Salsalate intoxication and ramifications of utilizing nonspecific analytical methods in estimating quantitative blood concentrations

Abstract

In a case involving poisoning with salsalate, a salicylate analogue, the initial blood concentration of the parent drug was underestimated because of the low cross-reactivity of the immunoassay used for the analysis. This resulted in unnecessary additional clinical and laboratory evaluations to find the cause of metabolic acidosis exhibited by the patient. Additional findings led to the conclusion that parent salsalate contributed to patient toxicity. For testing purposes, all salicylate compounds should not necessarily be classified into one salicylic acid category, and there must be detailed communication between the caregiver and the laboratory regarding the specific drug history.