A non-ischaemic cause of elevated troponin

Lefort, G.; D'Antonio, Claude; Caffery, Terrell

doi:10.1136/bcr-2014-203729

Cited by 4 publications

(1 citation statement)

References 24 publications

(28 reference statements)

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“…Measurement of troponins has replaced the creatine kinase-MB isoform as the biochemical test for cardiac involvement. However, with the widespread use of high-sensitivity troponin assays, reports of false-positive or false-negative results have come out in the adult population 2–4…”

Section: Introductionmentioning

confidence: 99%

False-positive troponin I elevation in a newborn with neonatal encephalopathy

et al. 2019

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Serum biomarkers of myocardial damage are commonly used in babies after perinatal asphyxia. We present a case report of a persistently troponin I elevation without evidence of clinical or instrumental signs of myocardial ischaemia in a baby with perinatal asphyxia. When the blood was mixed with polyethylene glycol we found that the troponin I levels were falsely elevated due to interfering antibodies. This case shows that analytical errors may still occur despite modern immunoassay systems and underlines the need for further investigations to identify false-positive values in case of disagreement between clinical conditions and laboratory values.

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Section: Introductionmentioning

confidence: 99%

False-positive troponin I elevation in a newborn with neonatal encephalopathy

et al. 2019

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Interferencia analítica en la determinación de troponina por anticuerpos heterófilos

Grados-Saso¹,

Escota-Villanueva²,

Alonso-Lorente³

et al. 2019

Revista Colombiana de Cardiología

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False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report

Akhtar

Dargan

Gaze

et al. 2020

European Heart Journal - Case Reports

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Background Troponin is a crucial biomarker for the diagnosis of an acute coronary syndrome (ACS). It rises in response to myocardial injury from significant acute myocardial ischaemia caused by obstructive coronary artery disease [‘classical’ myocardial infarction (MI)]. However, raised levels have also been noted in conditions not recognized as classical ACS. This may include MI with non-obstructed coronary arteries such as takotsubo cardiomyopathy and other acute or chronic conditions such as pulmonary embolus or chronic kidney disease. This is commonly labelled as a ‘falsely elevated’ troponin although there is some myocardial strain to explain the rise, such as an increase in cardiac oxygen demand. True ‘falsely elevated’ troponin, characterized by a persistent elevation in the absence of cardiac injury does occur and thought to be secondary to an immunoglobulin-troponin complex (macrotroponin). Case summary A 53-year-old gentleman with a background of diabetes, hypertension, hypercholesterolaemia, and hepatitis B was admitted with chest pain and persistently elevated cardiac troponin T (cTnT) levels. Investigations revealed unobstructed coronary arteries and a structurally normal, well-functioning heart. Subsequent biochemical analysis found the persistently elevated cTnT secondary to macrotroponin T. Discussion Macrotroponin, an immunoglobulin-troponin bound complex should be considered as a differential diagnosis when the biochemistry is not reflective of the clinical picture. Early recognition requires effective collaboration with the biochemistry laboratory for accurate diagnosis.

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A non-ischaemic cause of elevated troponin

Cited by 4 publications

References 24 publications

False-positive troponin I elevation in a newborn with neonatal encephalopathy

False-positive troponin I elevation in a newborn with neonatal encephalopathy

Interferencia analítica en la determinación de troponina por anticuerpos heterófilos

False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report

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