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Jamal T, Hennequin C, Gahoual R, Leyris A, Beaudeux JL, Baud FJ, Houzé P. Is Capillary Electrophoresis a New Tool to Monitor Acute Lithium Poisoning in Human?†. J Anal Toxicol 2019; 43:571-578. [PMID: 30877800 DOI: 10.1093/jat/bkz013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/03/2019] [Accepted: 02/20/2019] [Indexed: 01/24/2023] Open
Abstract
A 38-year-old man was admitted in the intensive care unit (ICU) after supposed ingestion of 504 sustained-release tablets of Theralithe™ corresponding ~200 g of lithium carbonate. At the admission, ~19.5 h after ingestion, the patient was conscious with trembling limbs, intense thirst, profuse sweats and vomiting and lithium serum concentration was 14.2 mmol/L. Toxicological screenings performed in urine and serum, were negative. Patient was treated with continuous extrarenal epuration by continue veno-venous hemodiafiltration starting (CCVHDF) 24 h post-admission and was carried on until 64 h. After 11 days in ICU, the patient was dismissed to the service without sequelae, and transferred to a psychiatric unit. To follow lithium concentrations in serum, urines and dialysates, we developed a simple, rapid and reliable method by capillary zone electrophoresis (CZE). Separation was achieved in 7 min. The method was linear between 0.14 and 1.44 mmol/L for serum samples, and between 0.07 and to 1.44 mmol/L for urines and dialysates. Limits of quantification were 0.15 mmol/L and 0.07 mmol/L for serum and others fluids, respectively. Intra- and inter-day precisions expressed as CV were systematically inferior to 12.1% for serum and 8.2% for other fluids. Results obtained regarding precision, accuracy, recovery and stability were satisfying, with recoveries ranging from 91.0 to 102.0%. Serum, urine and dialysate samples were measured using CZE and flame photometry. We observed a strong correlation between both methods as assessed by linear regression and Bland-Altman analysis. For the intoxicated patient, the assay was successfully applied to serum, urine and dialysates to determine the amount of lithium present in circulation and excreted. Lithium amounts in dialysates were estimated to correspond to 89% of total lithium excreted during CCVHF session while urine excretion account only for 11%.
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Affiliation(s)
- Tsandni Jamal
- Service de biochimie générale, Hôpital universitaire Necker-Enfants Malades, AP-HP, rue de Sèvres, Paris, France
| | - Carole Hennequin
- Service de biochimie générale, Hôpital universitaire Necker-Enfants Malades, AP-HP, rue de Sèvres, Paris, France
| | - Rabah Gahoual
- Laboratoire de chimie analytique, Faculté de Pharmacie, Université Paris Descartes, 4 avenue de l'Observatoire, Paris, France.,Unité de Technologies Biologiques et Chimiques pour la Santé (UTCBS), Paris 5-CNRS UMR8258 Inserm U1022, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Annie Leyris
- Laboratoire de chimie analytique, Faculté de Pharmacie, Université Paris Descartes, 4 avenue de l'Observatoire, Paris, France
| | - Jean-Louis Beaudeux
- Service de biochimie générale, Hôpital universitaire Necker-Enfants Malades, AP-HP, rue de Sèvres, Paris, France
| | - Frédéric J Baud
- Assistance Publique - Hôpitaux de Paris, Département d'Anesthésie et de Réanimation, Adult Intensive Care Unit, Centre hospitalo-universitaire Necker - Enfants Malades, 149 rue de Sèvres, Paris, Université Paris Descartes, France.,EA7323 Evaluation of Therapeutics and Pharmacology in Perinatality and Pediatrics - Hôpitaux Universitaires Cochin - Broca - Hôtel Dieu, Site Tarnier, Université Paris Descartes, Paris, France
| | - Pascal Houzé
- Service de biochimie générale, Hôpital universitaire Necker-Enfants Malades, AP-HP, rue de Sèvres, Paris, France.,Laboratoire de chimie analytique, Faculté de Pharmacie, Université Paris Descartes, 4 avenue de l'Observatoire, Paris, France.,Unité de Technologies Biologiques et Chimiques pour la Santé (UTCBS), Paris 5-CNRS UMR8258 Inserm U1022, Faculté de Pharmacie, Université Paris Descartes, Paris, France
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Lau HF, Quek NM, Law WS, Zhao JH, Hauser PC, Li SFY. Optimization of separation of heavy metals by capillary electrophoresis with contactless conductivity detection. Electrophoresis 2011; 32:1190-4. [DOI: 10.1002/elps.201000603] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 01/09/2011] [Accepted: 01/09/2011] [Indexed: 11/10/2022]
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Saito S, Nakano Y, Hikichi A, Suzuki R, Yoshimoto K, Maeda M, Aoyama M, Shibukawa M. Ultrasensitive CE for heavy metal ions using the variations in the chemical structures formed from new octadentate fluorescent probes and cationic polymers. Analyst 2011; 136:2697-705. [DOI: 10.1039/c0an00777c] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Schumacher PD, Woods NA, Schenk JO, Clark SB. Preconcentration of Trivalent Lanthanide Elements on a Mercury Film from Aqueous Solution Using Rotating Disk Electrode Voltammetry. Anal Chem 2010; 82:5663-8. [DOI: 10.1021/ac101180w] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Paul D. Schumacher
- Department of Chemistry, Washington State University, Pullman, Washington 99164
| | - Nicholas A. Woods
- Department of Chemistry, Washington State University, Pullman, Washington 99164
| | - James O. Schenk
- Department of Chemistry, Washington State University, Pullman, Washington 99164
| | - Sue B. Clark
- Department of Chemistry, Washington State University, Pullman, Washington 99164
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KrÌÃzÌek T, Breitbach ZS, Armstrong DW, TesarÌová E, Coufal P. Separation of inorganic and small organic anions by CE using phosphonium-based mono- and dicationic reagents. Electrophoresis 2009; 30:3955-63. [DOI: 10.1002/elps.200900416] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Johns C, Breadmore MC, Macka M, Ryvolová M, Haddad PR. Recent significant developments in detection and method development for the determination of inorganic ions by CE. Electrophoresis 2009; 30 Suppl 1:S53-67. [DOI: 10.1002/elps.200900103] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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