A Trap In Measuring Of Plasma Digoxin Level After Stopping Of A Treatment

Abstract

Summary:
In this paper, a course of the disease of a 68year-old patient treated with medigoxin for congestive heart failure is presented. After being withdrawn from his treatment at the hospital, the patient was administered spironolactone and turosemide. The plasma digoxin level at entry was 1.1 nmol/L, after five days it reached 3.2nmol/L, and after ten days was 2.3 nmol/L. The patient had a normal renal function. The interference of spironolactone and its metabolites with the thgoxin ‘radioimmunoassay was discussed as a possible explanation for this omena.

Discussion:
The case described here demonstrates a pr entation of a 68year-old patient with cardiac d compensation who had been treated with 0.1 mgo medigoxin daily for congestive heart failure until the admission to the hospital. On entry an e1ecu cardiogram indicated the PQinterva1 of 0.38 , suggesting the digitalis effect. During the treau the clinical picture of heart failure disappeare while plasma digoxin concentration disclosed highei and higher values, despite the withdrawal of’ medigoxin.