A non-ischaemic cause of elevated troponin
Guy Lefort1, Claude D'Antonio, Terrell Caffery
1Department of Emergency Medicine, LSU Health Baton Rouge, Baton Rouge, Louisiana, USA.
BMJ Case Reports
|April 8, 2014
Summary
Antibodies can interfere with troponin tests, causing falsely elevated results in patients with chest pain and normal coronary arteries. This highlights the importance of considering assay interference in diagnosis.
Area of Science:
- Clinical Chemistry
- Cardiology
- Immunology
Background:
- Elevated troponin levels are a key indicator of myocardial infarction.
- Accurate troponin measurement is crucial for diagnosing acute coronary syndromes.
Observation:
- A 27-year-old woman presented with chest pain and elevated troponin levels.
- Previous troponin elevations and cardiac catheterization with normal coronary arteries were noted.
- Troponin levels normalized upon repeat testing after adding ethylene glycol.
Findings:
- The normalization of troponin levels after ethylene glycol addition suggests heterophile antibody interference.
- This interference led to falsely elevated troponin measurements in the patient.
- Angiographically normal coronary arteries further supported a non-cardiac cause for troponin elevation.
Implications:
- Assay interference should be considered in patients with unexplained troponin elevations.
- Understanding antibody interference is critical for accurate cardiac biomarker interpretation.
- This case underscores the need for careful diagnostic evaluation beyond standard troponin assays.
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