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首页> 外文期刊>European Heart Journal - Case Reports >False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report
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False-positive troponin elevation due to an immunoglobulin-G-cardiac troponin T complex: a case report

机译：由于免疫球蛋白-G-Carciac肌钙蛋白T复合物，伪阳性肌钙蛋白升高：案例报告

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Background Troponin is a crucial biomarker for the diagnosis of an acute coronary syndrome (ACS). It rises in response to myocardial injury from significant acute myocardial ischaemia caused by obstructive coronary artery disease [‘classical’ myocardial infarction (MI)]. However, raised levels have also been noted in conditions not recognized as classical ACS. This may include MI with non-obstructed coronary arteries such as takotsubo cardiomyopathy and other acute or chronic conditions such as pulmonary embolus or chronic kidney disease. This is commonly labelled as a ‘falsely elevated’ troponin although there is some myocardial strain to explain the rise, such as an increase in cardiac oxygen demand. True ‘falsely elevated’ troponin, characterized by a persistent elevation in the absence of cardiac injury does occur and thought to be secondary to an immunoglobulin-troponin complex (macrotroponin). Case summary A 53-year-old gentleman with a background of diabetes, hypertension, hypercholesterolaemia, and hepatitis B was admitted with chest pain and persistently elevated cardiac troponin T (cTnT) levels. Investigations revealed unobstructed coronary arteries and a structurally normal, well-functioning heart. Subsequent biochemical analysis found the persistently elevated cTnT secondary to macrotroponin T. Discussion Macrotroponin, an immunoglobulin-troponin bound complex should be considered as a differential diagnosis when the biochemistry is not reflective of the clinical picture. Early recognition requires effective collaboration with the biochemistry laboratory for accurate diagnosis.
机译：背景技术肌钙蛋白是诊断急性冠状动脉综合征（ACS）的重要生物标志物。由于阻塞性冠状动脉疾病（古典'心肌梗死（MI）引起的显着急性心肌缺血，它升高了心肌损伤。但是，在不被认为是古典ACS的条件下也已经注意到募集水平。这可以包括具有非阻塞冠状动脉的MI，例如Takotubo心肌病和其他急性或慢性条件，如肺栓塞或慢性肾病。这通常标记为“虚假升高”的肌钙蛋白，尽管存在一些心肌菌株来解释升值，例如心脏需氧量的增加。真正的'虚假升高的'肌钙蛋白，其特征在于没有心脏损伤的持续升高确实发生并被认为是免疫球蛋白 - 肌钙蛋白复合物（MacroTroponin）。案例摘要A 53岁的绅士与糖尿病，高血压，高胆固醇症和乙型肝炎的背景有胸痛和持续升高的心肌肌钙蛋白T（CTNT）水平。调查揭示了无障碍的冠状动脉和结构正常，功能良好的心脏。随后的生物化学分析发现持续升高的CTNT次级的次次升高至MacroTroponinT.讨论Macrotroponin，当生物化学不反映临床图时，免疫球蛋白 - 肌钙蛋白结合复合物应被视为差异诊断。早期认可需要与生物化学实验室有效合作，以准确诊断。

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