A clinical and laboratory approach used to elucidate discordant results of high-sensitivity troponin T and troponin I

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059563" target="_blank" >RIV/00023001:_____/15:00059563 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/15:43909661

Result on the web

<a href="http://www.sciencedirect.com/science/article/pii/S0009898115001990" target="_blank" >http://www.sciencedirect.com/science/article/pii/S0009898115001990</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.cca.2015.03.046" target="_blank" >10.1016/j.cca.2015.03.046</a>

Result language

angličtina

Original language name

A clinical and laboratory approach used to elucidate discordant results of high-sensitivity troponin T and troponin I

Original language description

Background: Careful interpretation of discordant results in high-sensitivity troponin measurements is necessary in cases of suspect immunoassay interferences. We describe several procedures taken in a case of a polymorbid patient with chest pain, without clear evidence of myocardial necrosis and with increased high-sensitivity cardiac troponin T (hs-cTnT). We checked the Vafaie's algorithm for the evaluation of suspect interference in troponin measurements. Methods: We conducted a case report analysis, additional measurements, a dilution test and pretreatment of plasma with blocking agents. Results: Concentration of hs-cTnT (99th percentile of "healthy" population 14 ng/L) increased from 120.1 ng/L to 280.4 ng/L during an 8-month period and decreased to 216.3 ng/L during the following month with repeatedly negative troponin I (TnI), hs-cTnI, myoglobin and creatine kinase MB (CK-MB). Suspected false positivity of hs-cTnT was further confirmed by treatment of plasma with an antiheterophile blocking agent (hs-cTnT before treatment 280.4 ng/L, after 16.53/16.23 ng/L). This outcome was further confirmed by the manufacturer's experiments. Conclusions: The false-positive results of hs-cTnT were caused by the presence of extremely rare high molecular weight protein, presumably IgM, most likely HAMA (human anti-mouse antibody). Only the pre-treatment of plasma with a blocking agent provided a reliable indication of the interference. Cooperation among clinicians, laboratory personnel and the manufacturer is essential.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

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Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2015

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Clinica chimica acta

ISSN

0009-8981

e-ISSN

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Volume of the periodical

446

Issue of the periodical within the volume

June 15

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

4

Pages from-to

128-131

UT code for WoS article

000356745600022

EID of the result in the Scopus database

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