LOIS ALDWIN, PH.D.; DAVID S. KABAKOFF, PH.D
To the editor: Burgess and associates (1) have presented evidence that homogeneous enzyme immunoassay (EMIT; Syva Corporation, Palo Alto, California) yields falsely high results for phenytoin concentrations as compared with gas-liquid chromatography on samples from patients with end-stage renal disease. Serum phenytoin ascertainments for control patients with normal renal function were not statistically different for the two methods.
The authors tested the hypothesis that metabolite interference caused the apparent increase in phenytoin by measuring serum phenytoin concentration before and after hemodialysis in 16 patients. They found a median decrease in serum hydroxyphenyl phenylhydantoin (HPPH)-glucuronide, the major phenytoin metabolite, from 33.6
ALDWIN L, KABAKOFF DS. Serum Phenytoin Concentrations in Uremia. Ann Intern Med. ;95:785. doi: 10.7326/0003-4819-95-6-785_1
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Published: Ann Intern Med. 1981;95(6):785.
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