Use of fluorescence polarization immunoassay for salicylate to avoid positive/negative interference by bilirubin in the Trinder salicylate assay

Abstract

Background Significant positive bias of bilirubin in the Trinder salicylate method on automated analysers has been reported. Because the fluorescence polarization immunoassay (FPIA) for salicylate is also widely used in the clinical laboratory, we studied the potential interference of bilirubin in the salicylate FPIA.

Falsely elevated salicylate concentration in a patient with hypertriglyceridemia

“…The Trinder test is a colorimetric method, and many substances, including phenolic or aliphatic metabolites, can show reactions similar to salicylate [3]. Fluorescence polarization immunoassay is also available and uses a polyclonal antibody [4]. Additionally, an enzymatic method, which utilizes salicylate hydroxylase, is specific for salicylate and shows no interference [5].…”

Rapid determination of salicylic acid at screen printed electrodes

“…Patients attending Accident and Emergency services exhibiting a range of symptoms such as vomiting, abdominal pain, tinnitus, tachycardia and tachypnea could all too easily be suffering from salicylate poisoning [33][34][35][36]. The situation can be particularly complicated in paediatric cases where there can be a reluctance or inability of the subject to communicate.…”

Interferences in Therapeutic Drug Monitoring

“…However, immunoassays for acetaminophen and salicylate are free from such interferences [1,2]. Bilirubin is derived from the hemoglobin of aged or damaged red blood cells.…”