학술논문

'Troponinosis', the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report
Document Type
article
Source
Journal of Cardiovascular Development and Disease, Vol 10, Iss 9, p 378 (2023)
Subject
high-sensitivity troponin
acute coronary syndrome
immunoglobulin
laboratory tests
analytic interference
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
2308-3425
Abstract
Cardiac troponins are key diagnostic and prognostic biomarkers in acute myocardial infarction and, more generally, for the detection of myocardial injury. Since the introduction of the first immunochemistry methods, there has been a remarkable evolution in analytical performance, especially concerning a progressive improvement in sensitivity. However, the measurement of circulating troponins remains rarely susceptible to analytical interferences. We report a case of persistently elevated troponin I concentrations in a patient with known ischemic heart disease, which almost led to unnecessary diagnostic–therapeutic interventions. A prompt laboratory consultation by the cardiologist ultimately led to the identification of an analytical interference due to troponin macrocomplexes (macrotroponin) causing elevated troponin values in the absence of a clinical presentation compatible with myocardial damage.