IMR Press / RCM / Volume 19 / Issue 2 / DOI: 10.31083/j.rcm.2018.02.902
Open Access Case Review
False-positive Troponin I Assay elevation due to occult Mixed Cryoglobulinemic Vasculitis
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1 UC San Diego Department of Medicine - Pulmonary and Critical Care Fellowship, La Jolla, CA 92037-7381
2 UC San Diego Department of Medicine - Division of Nephrology, San Diego, CA 92161-9111
3 UC San Diego Department of Medicine - Division of Cardiovascular Medicine, La Jolla, CA 92037
Rev. Cardiovasc. Med. 2018 , 19(2), 73–75; https://doi.org/10.31083/j.rcm.2018.02.902
Published: 30 June 2018
Abstract
A 53-year-old man with active hepatitis C and cirrhosis presented with a vasculitic rash, myalgias, and fatigue, and was found to have an elevated cardiac troponin I up to 15.7 ng/mL with normal electrocardiogram, echocardiogram, and coronary angiogram prior to being discharged. Subsequently, during a similar presentation to another academically affiliated hospital, the patient had a normal cardiac troponin T (< 0.01 ng/mL). Upon his third presentation with significantly elevated troponin I to 15.98 ng/mL, the patient was found to have cryoglobulinemic vasculitis and elevated rheumatoid factor due to active hepatitis C, causing interference with the troponin I immunoassay. In conclusion, troponin I assays may have high false-positive values due to interference by rheumatoid factor and/or a polyclonal antibody found in cryoglobulinemia.
Keywords
Biomarkers
Troponin
Cryoglobulinemia
Acute coronary syndrome
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