Cargando…

Misleading Elevation of Troponin T caused by Polymyositis

BACKGROUND: Elevations of cardiac enzymes are commonly used to indicate myocardial ischemia, but they can be elevated due to other conditions. Different forms of Troponin (cTnT, sTnT, cTnI), can cause cross-reactivity in the Troponin T assay, leading to false positives. This report describes a patie...

Descripción completa

Detalles Bibliográficos
Autores principales: Dhir, Teena, Jiang, Ning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Master Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708267/
https://www.ncbi.nlm.nih.gov/pubmed/23847461
_version_ 1782276592591962112
author Dhir, Teena
Jiang, Ning
author_facet Dhir, Teena
Jiang, Ning
author_sort Dhir, Teena
collection PubMed
description BACKGROUND: Elevations of cardiac enzymes are commonly used to indicate myocardial ischemia, but they can be elevated due to other conditions. Different forms of Troponin (cTnT, sTnT, cTnI), can cause cross-reactivity in the Troponin T assay, leading to false positives. This report describes a patient with polymyositis who had elevated Troponin T, but no cardiac abnormalities. The purpose is to show that Troponin T, which is believed to be solely from cardiac muscle breakdown, can be seen in inflammatory muscle disease, so Troponin I should be used instead. DESCRIPTION: This is a case report of a 70-year-old woman with a history of diabetes, hypertension, gout and polymyositis, who presented with one-day history of lightheadedness and abdominal pain. To rule out myocardial ischemia, cardiac enzyme testing was ordered which showed elevated CK, CK-MB, and Troponin T. A full cardiac workup was performed which showed no signs of ischemia. Troponin I was <0.05 ng/mL, (normal). DISCUSSION: In inflammatory myositis, there are elevations in many cardiac markers due to non-cardiac causes, which could be related to muscle regeneration and gene expression. This is not seen certain isoforms of Troponin I, specifically cardiac Troponin I. CONCLUSION: In patients with history of diabetes and other comorbidities, silent myocardial ischemias should be ruled out. Non-cardiac elevations in Troponin T can be seen in patients with inflammatory, so Troponin I should be ordered to get an accurate interpretation. Patients with inflammatory myopathies can have elevations in CK, CK-MB, and Troponin T, but not Troponin I.
format Online
Article
Text
id pubmed-3708267
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Master Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-37082672013-07-11 Misleading Elevation of Troponin T caused by Polymyositis Dhir, Teena Jiang, Ning Int J Biomed Sci Case Report BACKGROUND: Elevations of cardiac enzymes are commonly used to indicate myocardial ischemia, but they can be elevated due to other conditions. Different forms of Troponin (cTnT, sTnT, cTnI), can cause cross-reactivity in the Troponin T assay, leading to false positives. This report describes a patient with polymyositis who had elevated Troponin T, but no cardiac abnormalities. The purpose is to show that Troponin T, which is believed to be solely from cardiac muscle breakdown, can be seen in inflammatory muscle disease, so Troponin I should be used instead. DESCRIPTION: This is a case report of a 70-year-old woman with a history of diabetes, hypertension, gout and polymyositis, who presented with one-day history of lightheadedness and abdominal pain. To rule out myocardial ischemia, cardiac enzyme testing was ordered which showed elevated CK, CK-MB, and Troponin T. A full cardiac workup was performed which showed no signs of ischemia. Troponin I was <0.05 ng/mL, (normal). DISCUSSION: In inflammatory myositis, there are elevations in many cardiac markers due to non-cardiac causes, which could be related to muscle regeneration and gene expression. This is not seen certain isoforms of Troponin I, specifically cardiac Troponin I. CONCLUSION: In patients with history of diabetes and other comorbidities, silent myocardial ischemias should be ruled out. Non-cardiac elevations in Troponin T can be seen in patients with inflammatory, so Troponin I should be ordered to get an accurate interpretation. Patients with inflammatory myopathies can have elevations in CK, CK-MB, and Troponin T, but not Troponin I. Master Publishing Group 2013-06 /pmc/articles/PMC3708267/ /pubmed/23847461 Text en © Teena Dhir et al. Licensee Master Publishing Group http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Dhir, Teena
Jiang, Ning
Misleading Elevation of Troponin T caused by Polymyositis
title Misleading Elevation of Troponin T caused by Polymyositis
title_full Misleading Elevation of Troponin T caused by Polymyositis
title_fullStr Misleading Elevation of Troponin T caused by Polymyositis
title_full_unstemmed Misleading Elevation of Troponin T caused by Polymyositis
title_short Misleading Elevation of Troponin T caused by Polymyositis
title_sort misleading elevation of troponin t caused by polymyositis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708267/
https://www.ncbi.nlm.nih.gov/pubmed/23847461
work_keys_str_mv AT dhirteena misleadingelevationoftroponintcausedbypolymyositis
AT jiangning misleadingelevationoftroponintcausedbypolymyositis