Falsely Elevated Serum Digoxin Levels Secondary to Endogenous Digoxin-like Immunoreactive Substances

Authors

  • Thomas J. Koobatian MD,

    1. The Medical College of Pennsylvania, Philadelphia Department of Emergency Medicine. Division of Toxicology
    Search for more papers by this author
  • James R. Roberts MD

    Corresponding author
    1. The Medical College of Pennsylvania, Philadelphia Department of Emergency Medicine. Division of Toxicology
    2. Mercy Catholic Medical Center, Philadelphia PA Department of Emergency Medicine Division of Toxicology
    Search for more papers by this author

Mercy Catholic Medical Center Miscrcordia Hospital 54th and Cedar Avenue Philadelphia. PA 19143

ABSTRACT

Endogenous digoxin-like immunoreactive substances (DLIS) are produced by the human body and can be significantly elevated in specific clinical conditions. Commercially available digoxin assays do not have the specificity to fully distinguish DLIS from exogenous digoxin, though DLIS do not possess the same therapeutic properties as do the drug. The resultant artificial elevation of a reported digoxin level or a completely factitious level in a patient not taking the drug can have clinically significant consequences.

Ancillary