Nazaret del Amo del Arco , Raquel Ramos Corral , Javier López Flores , Yessika M. Amezquita Orjuela , Alicia Roldán Pérez , Fernando Cava Valenciano
{"title":"Interferencia por ácido 2,4-diamino-N10-metilpteroico en la determinación de metotrexato tras la administración de glucarpidasa","authors":"Nazaret del Amo del Arco , Raquel Ramos Corral , Javier López Flores , Yessika M. Amezquita Orjuela , Alicia Roldán Pérez , Fernando Cava Valenciano","doi":"10.1016/j.labcli.2018.08.003","DOIUrl":null,"url":null,"abstract":"<div><p>High-dose methotrexate (MTX) treatment involves close monitoring of drug level in order to confirm its proper elimination. One of the possible side effects of this therapy is renal failure, causing accumulation of the drug, and therefore is a mayor toxic effect. Glucarpidase (carboxypeptidase-G2 or CPDG2) is a recombinant enzyme used to reduce MTX serum levels in patients who develop acute renal failure during high-dose MTX treatment. The enzyme reduces MTX concentration by 95-99% within 15-30<!--> <!-->minutes after the dose. Glucarpidase cleaves MTX into glutamate and 2,4-diamino-N10-methylpteroic acid, a minor and non-active metabolite. Cross-reactivity of 2,4-diamino-N10-methylpteroic acid in immunological assays of MTX has been previously reported, and is said to cause an enormous overestimation in serum MTX analysis. However immunoassay is a widely used technique for MTX analysis, being the main method for its determination in most clinical laboratories.</p><p>An interference case report is presented and MTX analysis in serum samples by liquid chromatography coupled with Ultra-High Resolution Q-Time of Flight Mass Spectrometry (LC-UHR-QTOF) is described.</p></div>","PeriodicalId":101105,"journal":{"name":"Revista del Laboratorio Clínico","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista del Laboratorio Clínico","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S188840081830076X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
High-dose methotrexate (MTX) treatment involves close monitoring of drug level in order to confirm its proper elimination. One of the possible side effects of this therapy is renal failure, causing accumulation of the drug, and therefore is a mayor toxic effect. Glucarpidase (carboxypeptidase-G2 or CPDG2) is a recombinant enzyme used to reduce MTX serum levels in patients who develop acute renal failure during high-dose MTX treatment. The enzyme reduces MTX concentration by 95-99% within 15-30 minutes after the dose. Glucarpidase cleaves MTX into glutamate and 2,4-diamino-N10-methylpteroic acid, a minor and non-active metabolite. Cross-reactivity of 2,4-diamino-N10-methylpteroic acid in immunological assays of MTX has been previously reported, and is said to cause an enormous overestimation in serum MTX analysis. However immunoassay is a widely used technique for MTX analysis, being the main method for its determination in most clinical laboratories.
An interference case report is presented and MTX analysis in serum samples by liquid chromatography coupled with Ultra-High Resolution Q-Time of Flight Mass Spectrometry (LC-UHR-QTOF) is described.
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