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A Case of Pseudo-Elevation of CK-MB without Myocardial Infarction
Background:
CK-MB is a subtype of creatine kinase isoenzyme, mainly present in myocardial tissue. When myocardial tissue damage is severe, CK-MB is released into the blood, and the serum level significantly increases, which is an important indicator for diagnosing acute myocardial infarction.
Methods:
We reported a case of pseudo-elevation of CK-MB without acute myocardial infarction.
Results:
The immunosuppressive assay showed that the activity of CK-MB isoenzyme was 903.0 U/L, which was significantly increased. The patient underwent examinations such as cardiac ultrasound and coronary artery imaging, and no obvious abnormalities were found. Suspected interference, CK-MB was measured using mass immunoassay, and the result was 1.96 ng/mL, which is within the normal range.
Conclusions:
When the CK-MB level (immunosuppressive assay) abnormally increases but clinical examination does not support the diagnosis of acute myocardial infarction, laboratory personnel should be aware of the short-comings of this method and use mass immunoassay to detect CK-MB to eliminate interference, and avoid unnecessary examinations and treatments for patients due to inaccurate results.
Insights
Pseudo-elevation of creatine kinase-MB (CK-MB) can occur without heart damage. Mass immunoassays can help confirm true CK-MB levels, preventing misdiagnosis of myocardial infarction.
Area of Science:
- Clinical Biochemistry
- Cardiology
Background:
- Creatine kinase-MB (CK-MB) is a key biomarker for diagnosing acute myocardial infarction.
- Elevated serum CK-MB levels typically indicate myocardial tissue damage.
Observation:
- A case presented with significantly elevated CK-MB levels (903.0 U/L) via immunosuppressive assay.
- Cardiac ultrasound and coronary angiography revealed no abnormalities, suggesting potential assay interference.
Findings:
- Mass immunoassay for CK-MB yielded a normal result (1.96 ng/mL), contradicting the immunosuppressive assay.
- This discrepancy highlights the potential for false positives with certain CK-MB assay methods.
Implications:
- Laboratory professionals should consider assay interference when CK-MB results conflict with clinical findings.
- Utilizing mass immunoassays can prevent misdiagnosis of myocardial infarction and unnecessary patient interventions.
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