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ARTICLE |

Discrepancies in the Radioimmunoassay for Digoxin FREE

Jordan L. Holtzman, MD, PhD; Rex B. Shafer, MD
JAMA. 1975;233(7):817-817. doi:10.1001/jama.1975.03260070075033
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In recent years, the radioimmunoassay for digoxin has gained widespread acceptance for identifying digoxin intoxication in patients. It is of particular value in those patients who have manifestations of arteriosclerotic cardiovascular disease as arrhythmias, which are also the signs of digitalis intoxication. Even in the initial studies on the clinical application of this assay, there was a substantial overlap in the digoxin levels observed for the intoxicated and nonintoxicated patients.1 Several workers have suggested that some of this overlap could be a result of the assay itself not giving the true value for the serum concentration.2—4 In a recent study, we have found that there is indeed a group of patients for whom the determination of serum digoxin concentrations will give an erroneously low value.5

In the routine clinical application of the radioimmunoassay, the fraction of labeled drug bound to antibody is compared to a calibration curve

REFERENCES

Smith TW, Butler VP, Haber E:  Digoxin intoxication: The relationship of clinical presentation to serum digoxin concentrations . J Clin Invest 49:2377-2386, 1970;.
Anggard EE, Chew LP, Kalman SM:  A source of error in digoxin radioimmunoassay . N Engl J Med 287:935, 1972;.
Fogelman AM, LaMont JT, Finkelstein S, et al:  Fallibility of plasma digoxin in differentiating toxic from nontoxic patients . Lancet 2:727-729, 1971;.
Burnett GH, Conklin RL, Wasson GW:  Variability of standard curves in radioimmunoassay of plasma digoxin . Clin Chem 19:725-726, 1973;.
Holtzman JL, Shafer RB, Erickson RR:  Methodological causes of discrepancies in radioimmunoassay for digoxin in human serum . Clin Chem 20:1194-1198, 1974;.

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Smith TW, Butler VP, Haber E:  Digoxin intoxication: The relationship of clinical presentation to serum digoxin concentrations . J Clin Invest 49:2377-2386, 1970;.
Anggard EE, Chew LP, Kalman SM:  A source of error in digoxin radioimmunoassay . N Engl J Med 287:935, 1972;.
Fogelman AM, LaMont JT, Finkelstein S, et al:  Fallibility of plasma digoxin in differentiating toxic from nontoxic patients . Lancet 2:727-729, 1971;.
Burnett GH, Conklin RL, Wasson GW:  Variability of standard curves in radioimmunoassay of plasma digoxin . Clin Chem 19:725-726, 1973;.
Holtzman JL, Shafer RB, Erickson RR:  Methodological causes of discrepancies in radioimmunoassay for digoxin in human serum . Clin Chem 20:1194-1198, 1974;.
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