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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 25, Number 7, October, pp. 621-624
TECHNICAL NOTE: Rapid Detection of Benzoylecgonine in Vitreous
Humor by Enzyme Immunoassay*
Chris W. Chronister, Jessica C. Walrath, and Bruce
A. Goldberger
Department of Pathology, Immunology, and Laboratory Medicine, University of
Florida College of Medicine, P.O. Box 100275, Gainesville, Florida 32610-0275
The usual specimens submitted by a medical examiner for toxicological
analysis include blood, urine, bile, vitreous humor, stomach contents, and solid-organ
tissue. The detection of drugs in these specimens typically involves a combination
of techniques including colorimetry, immunoassay, and gas chromatography. Although
many laboratories rely principally on urine for the detection of drugs of abuse
by immunoassay, these assays may be applied to other specimen types. An evaluation
of Microgenics Corporations cloned enzyme donor immunoassay (CEDIA®)
was conducted in order to evaluate its use in the detection of cocaine/cocaine
metabolites in vitreous humor specimens. During a 14-month period, 392 vitreous
humor specimens were analyzed by the CEDIA DAU Cocaine assay. Instrument parameters
were set according to published manufacturers guidelines. All presumptive
positive immunoassay results prompted confirmatory testing and quantitation
by gas chromatographymass spectrometry (GCMS) of other specimens
including blood. Vitreous humor specimens were not tested by GCMS. Using
a ~100-ng/mL cutoff, the CEDIA assay produced 23 presumptive positive results,
22 of which were confirmed by GCMS. The only specimen which could not
be confirmed, elicited an immunoassay screen value near the cutoff limit. Routine
analysis of blood, urine, bile, and/or bladder wash specimens by gas chromatographynitrogen
phosphorus detection revealed the presence of cocaine/cocaine metabolites in
only 7 (31.8%) of the 22 confirmed cases. The concentration ranges of cocaine
and benzoylecgonine in the blood specimens were none detected to 337 ng/mL and
17 to 8598 ng/mL, respectively. Cocaethylene was not detected in these cases.
Analysis of vitreous humor specimens by CEDIA improved the detection rate of
cocaine/cocaine metabolites by 0.7% in the cases submitted to our laboratory
during the 14-month period.
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