Akrep Antivenomunun İmmunassay Yöntem Üzerindeki İnterferans Etkisinin Deneysel Araştırılması

Abstract

Skorpionizmde özgün tedavi yöntemi antivenom kullanımıdır. Antivenomların klinik olarak alerjik reaksiyonlara yol açtığı bilinse de antikor özelliğinden dolayı immunassay ölçüm yöntemlerinde oluşturabileceği interferans etkisi bilinmemektedir. İmmunassay metotlar hormon, kardiyak markır, tümör markırı ve pek çok büyük moleküllü parametrenin ölçülmesinde kullanılmaktadır. Birçok çalışmada farklı antikorların neden olduğu interferans gösterilmiş fakat aynı durumun antivenomlar tarafından da olabileceği gösterilmemiştir. Bu çalışmanın amacı akrep antivenomunun immunassay yöntemde interferans oluşturma potansiyelinin deneysel olarak araştırılmasıdır. Bu çalışmada akrep antivenomunun 23 adet immunassay test üzerindeki interferans etkileri incelendi. Çalışma sonucunda serbest T3 seviyesi yüksek titre antivenomda %13.09’luk bir sapma gösterdi. Fertilite testlerinden progesteron seviyesi düşük titrede %10.58 oranında, testosteron seviyesi %14.57 oranında negatif interferansa uğramıştır. Parathormon seviyelerinde düşük ve yüksek titre antivenom maruziyetinde %11-16 arasında negatif interferans gözlenmiştir. Kütle kreatin kinaz MB testi %7.35-21.58 oranında negatif interferansa, troponin I testi %3-8.9 oranında pozitif interferansa uğramıştır. Özellikle kardiyak testlerin yanlış negatif bulunması kardiyak komplikasyonların atlanmasına neden olacağından hayati öneme sahiptir. Tümör markırları içinde en çok negatif interferansa maruz kalan test %28.65-28.9 oranı ile kanser antijeni 19-9 oldu. Çoğu klinisyen tarafından bilinmeyen interfernas etki immunassay testlerde hatalı ölçüme neden olabilecek birer risk faktörüdür. Tedavi sırasında oluşabilecek bu tür durumlarla karşılaşmamak için hastane bilgi yönetim sistemleri ile klinisyenler önceden uyarılabilir. İnterferansın neden olduğu hatalı test sonuçları malpraktislerle karşılaşma riskini arttırmaktadır. Sonuç olarak klinisyenler immunassay tekniklerden daha iyi yöntemler bulunana kadar laboratuvar testlerini değerlendirirken interferansa karşı dikkatli olmalıdır.

Keywords

• Skorpionizm,Antivenom,İnterferans,İmmunassay

Experimental Investigation of Interference Effect of Scorpion Antivenom on Immunoassay Method

Abstract

The original treatment of scorpionism is intravenous antivenom infusion. It is known that antivenom causes clinically allergic reactions, however potential interference effect of scorpion antivenom is unknown .  The aim of present study was to investigate the potential of antivenom interference in immunosassay methods. In this study, 50 uL and 100 uL scorpion antivenom was added to 23 immunassay tests used for measuring T3, progesterone, testosterone, parathormone, creatin kinase, cancer antigen and troponin-I concentrations. The free T3 level showed a deviation of 13.09% in high titer antivenom.Progesterone levels were low in the fertility test at 10.58% and testosterone level was 14.57% at the low level. Rate of free T3 deviation was 13.09% in high titer of antivenom. In fertility tests, it was observed that levels of progesterone and testosterone decreased between 10.58-14.57% in low titre antivenom exposure. Negative interference was observed between 11-16% in low and high titre antivenom at parathomone levels.Mass creatine kinase MB test exposured 7.35-21.58% negative interference and troponin-I test introduced positive interference. Especially, the false negative results of cardiac test have a vital proposition because it will cause cardiac complications to be skipped. The most negative interference was observed for Cancer Antigen 19-9 concentration with a rate of 28.65-28.9%. For all immunoassay measurements, every antibody is a risk factor that cause false negative or positive test result. Therefore, clinicians should be careful to confirm diagnostic laboratory tests until better methods than immunoassay techniques are found.

Keywords

• Scorpionism,Antivenom,Interference,Immunoassay

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