title: Determination of monoethylglycinexylidide by fluorescence polarization immunoassay in highly icteric serum samples: modified precipitation procedure and HPLC compared.
abstract: Hyperbilirubinemia, which frequently occurs in severe liver disease, interferes with the fluorescence polarization immunoassay (FPIA) monoethylglycinexylidide (MEGX) assay manufactured by Abbott Diagnostics. Because the MEGX test is particularly helpful in this clinical situation, strategies have been developed to overcome this problem. Precipitation of serum with the Abbott Digoxin II precipitation reagent eliminates bilirubin. Therefore, we compared FPIA results after precipitation of 81 icteric samples from 27 MEGX tests to results obtained using a validated HPLC method. The precipitation did not substantially alter the performance characteristics of FPIA: detection limit, 8 microg/L; between-days imprecision, 5.3-6.2%; recovery, 102-104% (50-200 microg/L). This pretreatment of serum did not eliminate all interference, and only a poor correlation was observed between serum MEGX concentrations measured with HPLC or modified FPIA (r2 = 0.46; S(y/x) = 20.0 microg/L). In contrast, MEGX formation values calculated by subtraction of the prelidocaine MEGX concentration were in close agreement (r2 = 0.98; S(y/x) = 2.3 microg/L). Because only MEGX formation is clinically relevant, this modified FPIA procedure offers a simple and rapid alternative to HPLC.
authors.affiliation: Abteilung Klinische Chemie, Georg-August-Universität Göttingen, Germany. eschuetz@med.unigoettingen.de
authors.forename: E
authors.initials: E
authors.lastname: Schütz
authors.forename: M
authors.initials: M
authors.lastname: Shipkova
authors.forename: P D
authors.initials: PD
authors.lastname: Niedmann
authors.forename: E
authors.initials: E
authors.lastname: Wieland
authors.forename: V W
authors.initials: VW
authors.lastname: Armstrong
authors.forename: M
authors.initials: M
authors.lastname: Oellerich
mesh_terms: D011232:Chemical Precipitation; D002851:Chromatography, High Pressure Liquid; D016231:Fluorescence Polarization Immunoassay; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood* / Q000150:complications; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000097:blood; D016031:Liver Transplantation; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D011933:Reagent Kits, Diagnostic; D008012:Lidocaine; C001173:monoethylglycinexylidide