Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check

A 78-year-old woman presented twice with high sensitivity troponin I (hs-TnI) elevation. Two cardiac catheterizations showed nonocclusive coronary artery disease, and 2 cardiac magnetic resonance imaging scans were normal. With these investigations unable to explain the troponin I (hs-TnI) elevation...

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Detalles Bibliográficos
Autores principales: Saunders, Alexandra, Tsui, Albert K.Y., Alhulaimi, Naji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347847/
https://www.ncbi.nlm.nih.gov/pubmed/34401704
http://dx.doi.org/10.1016/j.cjco.2021.02.014
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author Saunders, Alexandra
Tsui, Albert K.Y.
Alhulaimi, Naji
author_facet Saunders, Alexandra
Tsui, Albert K.Y.
Alhulaimi, Naji
author_sort Saunders, Alexandra
collection PubMed
description A 78-year-old woman presented twice with high sensitivity troponin I (hs-TnI) elevation. Two cardiac catheterizations showed nonocclusive coronary artery disease, and 2 cardiac magnetic resonance imaging scans were normal. With these investigations unable to explain the troponin I (hs-TnI) elevation, alternate troponin samples were sent to check for assay interference. Results from these troponin assays were low. With the patient having elevated rheumatoid factor as a potential contributor to assay interference, the lab reanalyzed the samples using heterophile antibody blocking tubes, revealing lower hs-TnI levels. This case serves as a reminder to consider assay interference when the clinical picture is inconsistent with ischemia.
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spelling pubmed-83478472021-08-15 Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check Saunders, Alexandra Tsui, Albert K.Y. Alhulaimi, Naji CJC Open Case Report A 78-year-old woman presented twice with high sensitivity troponin I (hs-TnI) elevation. Two cardiac catheterizations showed nonocclusive coronary artery disease, and 2 cardiac magnetic resonance imaging scans were normal. With these investigations unable to explain the troponin I (hs-TnI) elevation, alternate troponin samples were sent to check for assay interference. Results from these troponin assays were low. With the patient having elevated rheumatoid factor as a potential contributor to assay interference, the lab reanalyzed the samples using heterophile antibody blocking tubes, revealing lower hs-TnI levels. This case serves as a reminder to consider assay interference when the clinical picture is inconsistent with ischemia. Elsevier 2021-03-03 /pmc/articles/PMC8347847/ /pubmed/34401704 http://dx.doi.org/10.1016/j.cjco.2021.02.014 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Saunders, Alexandra
Tsui, Albert K.Y.
Alhulaimi, Naji
Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title_full Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title_fullStr Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title_full_unstemmed Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title_short Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check
title_sort persistent troponin elevation in the setting of an elevated rheumatoid factor: when it pays to double check
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347847/
https://www.ncbi.nlm.nih.gov/pubmed/34401704
http://dx.doi.org/10.1016/j.cjco.2021.02.014
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