Abstract

REPILADO-ALVAREZ, A; ROMERO-LOPEZ, R; HERNANDEZ-TERCIADO, F  and  SANTIAGO-PRIETO, E. Antidigoxin antibodies and renal failure: rebound toxicity. A case report. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.4, pp.395-396.  Epub Oct 23, 2023. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x20220004000013.

Anti-digoxin antigen-binding fragments (Fab) are indicated in life-threatening situations associated with digitalis toxicity. The elimination of anti-digoxin Fab occurs through the renal route. The cardiac alterations associated with this toxicity translate into oligoanuria. Sinceneither digoxin nor Fab-digoxin complexes can be removed by hemofiltration or hemodialysis, the presence of renal failure is an important limitation for the treatment with anti-digoxin Fab of patients with digitalis toxicity.

The case of a patient with renal insufficiency and digitalis toxicity is described, who were administered Fab antidigoxin on 2 occasions. At 61 hours after the first administration, a rebound effect in digoxin levels was observed. This same situation was repeated 38 hours after the second administration of the antidote. We found a correlation between the patient's clinical status and the analytical determinations, which suggests that, after the two administrations of the antidote, there was a rebound effect.

Keywords : Antibodies; digoxin; drug toxicity; renal insufficiency.

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