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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11120/15:43909661

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_x - Nezařazeno - Článek v odborném periodiku (Jimp, Jsc a Jost)

CEP obor

FA - Kardiovaskulární nemoci včetně kardiochirurgie

OECD FORD obor

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Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2015

Kód důvěrnosti údajů

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

Název periodika

Clinica chimica acta

ISSN

0009-8981

e-ISSN

—

Svazek periodika

446

Číslo periodika v rámci svazku

June 15

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

4

Strana od-do

128-131

Kód UT WoS článku

000356745600022

EID výsledku v databázi Scopus

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