False positive amphetamines and 3,4-methylenedioxymethamphetamine immunoassays in the presence of metoprolol-two cases reported in clinical toxicology.

Autor:	Leclercq M; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France., Soichot M; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France., Delhotal-Landes B; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France., Bourgogne E; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France., Gourlain H; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France., Mégarbane B; Service de Réanimation Médicale et Toxicologique, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France.; INSERM UMRS-1144, Universités Paris-Descartes et Paris-Diderot, 4 Avenue de l'Observatoire, Paris 75006, France., Labat L; Service de Toxicologie, Hôpital Lariboisière, AP-HP, 2 Rue Ambroise Paré, Paris 75010, France.; INSERM UMRS-1144, Universités Paris-Descartes et Paris-Diderot, 4 Avenue de l'Observatoire, Paris 75006, France.
Jazyk:	angličtina
Zdroj:	Journal of analytical toxicology [J Anal Toxicol] 2020 Mar 07; Vol. 44 (2), pp. 200-205.
DOI:	10.1093/jat/bkz051
Abstrakt:	Amphetamines, frequently used recreational drugs with high risk of toxicity, are commonly included in urine drug screens. This screening is based on enzyme immunoassay, which is a quick and easy-to-perform technique, but may lack specificity resulting from cross-reactivity with other compounds, causing false positive results. We present two cases of presumed false positive MULTIGENT® amphetamine/methamphetamine and MULTIGENT® ecstasy (Abbott®) immunoassays with the beta-blocker metoprolol. Both metoprolol-poisoned patients presented positive urine screening despite no history of drug abuse. No confirmation for amphetamine molecular structures was found with gas chromatography-mass spectrometry. The cross-reactivity was further investigated by doping urine samples with metoprolol and its two major phase-I metabolites. Metoprolol showed positive results for both amphetamine and MDMA tests at low concentrations (200 and 150 μg/mL, respectively). Metoprolol metabolites cross-reacted with the amphetamines immunoassay only, but at higher concentrations (i.e., 2000 μg/mL for α-hydroxymetoprolol and 750 μg/mL for O-demethylmetoprolol). In conclusion, false positive results in amphetamines and MDMA immunoassays are possible in the presence of metoprolol. Toxicologists should be aware of frequent analytical interferences with immunoassays and a detailed medication history should be taken into consideration for interpretation. In vitro investigation of suspected cross-reactivity should include not only the parent drug but also its related metabolites. (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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