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Troponinförhöjning utan hjärtskada: En diagnostisk fallgrop vid analytisk interferens

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Title: Troponinförhöjning utan hjärtskada: En diagnostisk fallgrop vid analytisk interferens
Troponin elevation without myocardial injury - a diagnostic pitfall in cases of analytical interference
Authors: Mahmoud, Ahmad, Hammarlund, Peter, Ekström, Ulf, Mokhtari, Arash, David Dolata, Carl, Engberg, Anna, Svensson, Joel, Bjellerup, Per, Hammarsten, Ola
Contributors: Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Cardiology, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Kardiologi, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Section II, Clinical Sciences, Helsingborg, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Sektion II, Kliniska Vetenskaper, Helsingborg, Originator, Lund University, Faculty of Medicine, Department of Clinical Sciences, Lund, Infect@LU, Lunds universitet, Medicinska fakulteten, Institutionen för kliniska vetenskaper, Lund, Infect@LU, Originator, Lund University, Faculty of Medicine, Department of Laboratory Medicine, Division of Clinical Chemistry and Pharmacology, Malaria and Babesia, Lunds universitet, Medicinska fakulteten, Institutionen för laboratoriemedicin, Avdelningen för klinisk kemi och farmakologi, Malaria och Babesia, Originator, Lund University, Faculty of Medicine, Department of Laboratory Medicine, Division of Clinical Chemistry and Pharmacology, Lunds universitet, Medicinska fakulteten, Institutionen för laboratoriemedicin, Avdelningen för klinisk kemi och farmakologi, Originator, Lund University, Faculty of Medicine, Department of Translational Medicine, Clinical Chemistry, Malmö, Lunds universitet, Medicinska fakulteten, Institutionen för translationell medicin, Klinisk kemi, Malmö, Originator
Source: Lakartidningen. 123
Subject Terms: Medical and Health Sciences, Clinical Medicine, Cardiology and Cardiovascular Disease, Medicin och hälsovetenskap, Klinisk medicin, Kardiologi och kardiovaskulära sjukdomar
Description: High-sensitive cardiac troponins are essential biomarkers in the diagnostics of myocardial infarction. However, analytical interference such as macrotroponin, where troponin forms stable complexes with endogenous antibodies, can lead to persistently elevated levels without actual myocardial injury. The first case report presents a young woman with recurrent chest pain and prolonged troponin I elevation over several years, which ultimately could be attributed to macrotroponin I. The second case report describes a young man presenting with intermittent chest pain and stable troponin I elevation. Following extensive investigations, the elevation was ultimately attributed to macrotroponin. These cases highlight the clinical importance of recognizing this diagnostic pitfall, especially when elevated troponin level lacks correlation with symptoms, ECG or imaging findings. In case of suspected macrotroponin, contact your local laboratory for further investigation.
Access URL: https://media.arto.se/app/uploads/sites/11/2025/10/20100903/25107.pdf
Database: SwePub
Description
Abstract:High-sensitive cardiac troponins are essential biomarkers in the diagnostics of myocardial infarction. However, analytical interference such as macrotroponin, where troponin forms stable complexes with endogenous antibodies, can lead to persistently elevated levels without actual myocardial injury. The first case report presents a young woman with recurrent chest pain and prolonged troponin I elevation over several years, which ultimately could be attributed to macrotroponin I. The second case report describes a young man presenting with intermittent chest pain and stable troponin I elevation. Following extensive investigations, the elevation was ultimately attributed to macrotroponin. These cases highlight the clinical importance of recognizing this diagnostic pitfall, especially when elevated troponin level lacks correlation with symptoms, ECG or imaging findings. In case of suspected macrotroponin, contact your local laboratory for further investigation.
ISSN:00237205
16527518