Akrep Antivenomunun İmmunassay Yöntem Üzerindeki İnterferans Etkisinin Deneysel Araştırılması

Yıl 2018, Cilt: 7 Sayı: 2, 179 - 185, 27.12.2018

Ataman Gönel

https://doi.org/10.31196/huvfd.508979

Öz

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.

Anahtar Kelimeler

Skorpionizm, Antivenom, İnterferans, İmmunassay

Experimental Investigation of Interference Effect of Scorpion Antivenom on Immunoassay Method

Öz

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.

Anahtar Kelimeler

Scorpionism, Antivenom, Interference, Immunoassay

Kaynakça

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