1. Ingestion of false hellebore plants can cross-react with a digoxin clinical chemistry assay.
- Author
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Bechtel, L.K., Lawrence, D.T., Haverstick, D., Powers, J.S., Wyatt, S.A., Croley, T., and Holstege, C.P.
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VERATRUM viride ,FALSE hellebores ,DIGOXIN ,TOXICOLOGY of poisonous plants ,IMMUNOASSAY ,IMMUNOGLOBULINS ,STEROIDAL alkaloids - Abstract
Introduction. We report a case of digoxin-like toxicity because of ingestion of foraged plants. This patient presented with nausea, vomiting, bradycardia, and hypotension after ingesting Veratrum viride (false hellebore). The patient's serum specimen demonstrated a positive digoxin level (0.38 ng/mL) measured by a clinical tubidimetric immunoassay. We hypothesize that steroidal alkaloid compounds contained in V. viride cross-react with the Multigent
™ Digoxin immunoassay reagent antibodies. Results. Plant extracts from V. viride demonstrated cross-reactivity to Multigent™ reagent antibodies but did not bind therapeutic DigiFab™ antibodies. Gas chromatography/ mass spectrometry analyses identified several steroidal alkaloid compounds present in the V. viride extracts: jervine, ribigirvine, solanidine, and veratraman. Conclusions. This study indicates that compounds extracted from V. viride can cross-react with a clinical Digoxin immunoassay. Yet these extracts did not bind DigiFab™ antibody fragments used for therapeutic intervention. Providers should not unnecessarily administer DigiFab™ fragments as an antidote in symptomatic V. viride toxic patients. [ABSTRACT FROM AUTHOR]- Published
- 2010
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