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Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?

A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was based on...

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Autores principales: Rossi, Valentina A., Gawinecka, Joanna, Dimitriou, Florentia, von Eckardstein, Arnold, Dummer, Reinhard, Ruschitzka, Frank, Matter, Christian M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375180/
https://www.ncbi.nlm.nih.gov/pubmed/37021424
http://dx.doi.org/10.1002/ehf2.14360
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author Rossi, Valentina A.
Gawinecka, Joanna
Dimitriou, Florentia
von Eckardstein, Arnold
Dummer, Reinhard
Ruschitzka, Frank
Matter, Christian M.
author_facet Rossi, Valentina A.
Gawinecka, Joanna
Dimitriou, Florentia
von Eckardstein, Arnold
Dummer, Reinhard
Ruschitzka, Frank
Matter, Christian M.
author_sort Rossi, Valentina A.
collection PubMed
description A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was based on the typical time window after ICI, recurrence upon re‐challenge, elevations of CK, high‐sensitive troponin T (hs‐TnT) and I (hs‐TnI), mild NT‐proBNP increase, and positive magnetic resonance imaging criteria. Notably, hsTnI was found to more rapidly increase and fall and to be more heart‐specific than TnT in the context of ICI‐related myocarditis. This led to ICI therapy withdrawal and switch to a less effective systemic therapy. This case report highlights the differential value of hs‐TnT and hs‐TnI for diagnosis and monitoring of ICI‐related myositis and myocarditis.
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spelling pubmed-103751802023-07-29 Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? Rossi, Valentina A. Gawinecka, Joanna Dimitriou, Florentia von Eckardstein, Arnold Dummer, Reinhard Ruschitzka, Frank Matter, Christian M. ESC Heart Fail Case Reports A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was based on the typical time window after ICI, recurrence upon re‐challenge, elevations of CK, high‐sensitive troponin T (hs‐TnT) and I (hs‐TnI), mild NT‐proBNP increase, and positive magnetic resonance imaging criteria. Notably, hsTnI was found to more rapidly increase and fall and to be more heart‐specific than TnT in the context of ICI‐related myocarditis. This led to ICI therapy withdrawal and switch to a less effective systemic therapy. This case report highlights the differential value of hs‐TnT and hs‐TnI for diagnosis and monitoring of ICI‐related myositis and myocarditis. John Wiley and Sons Inc. 2023-04-06 /pmc/articles/PMC10375180/ /pubmed/37021424 http://dx.doi.org/10.1002/ehf2.14360 Text en © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Reports
Rossi, Valentina A.
Gawinecka, Joanna
Dimitriou, Florentia
von Eckardstein, Arnold
Dummer, Reinhard
Ruschitzka, Frank
Matter, Christian M.
Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title_full Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title_fullStr Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title_full_unstemmed Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title_short Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
title_sort value of troponin t versus i in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10375180/
https://www.ncbi.nlm.nih.gov/pubmed/37021424
http://dx.doi.org/10.1002/ehf2.14360
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