Heterophile antibodies, false-positive troponin, and acute coronary syndrome: a case report indicating a pitfall in
Nenad Lakusic1,2,3, Ivana Sopek Merkas1, Daren Lucinger1
1Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Croatia.
Background:
Heterophile antibodies are one of the most common causes of false-positive troponin.
Case Summary:
We report a case of a 53-year-old woman with false-positive troponin elevation and a clinical presentation understood and treated as non-ST-elevation acute coronary syndrome. Because of chronic basal elevation of troponin (at a 'plateau' level) and chest pain, the patient underwent several invasive coronary angiograms until false-positive increase of troponin due to heterophile antibodies was suspected. Borderline stenosis of a left circumflex coronary artery found on first coronary angiogram was a coincidental finding and heterophile antibodies in the patient's serum were confirmed.
Discussion:
This interesting case report aims to remind the clinicians about the possibility of false-positive troponin level due to laboratory analytical interference caused by heterophile antibodies. In this case, it is important to suspect false-positive troponin elevation, even when coronary artery disease is found. This rare and less mentioned and/or recognized cause of troponin elevation may lead to unnecessary invasive diagnostics and aggressive treatment of patients.
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