Schwarzmeier Josef D, Hamwi Ahmad, Preisel Martin, Resl Christoph, Preusser Matthias, Sluga Elfriede, Horcher Ernst, Shehata Medhat M
Hematology Department, Internal Medicine I, Medical University of Vienna, A-1097 Vienna, Austria.
Hum Pathol. 2005 Aug;36(8):917-21. doi: 10.1016/j.humpath.2005.06.009.
Cardiac troponin T (cTnT) is considered as a specific marker for acute myocardial infarction. Here, we present a case with elevated cTnT, determined by a third-generation assay, without signs of a myocardial lesion. Routine investigation of a 66-year-old female patient with indolent B-cell lymphoma revealed increased serum levels of creatine kinase (CK), MB fraction of CK (CK-MB), and cTnT, although she did not complain of cardiac symptoms. Electrocardiographic monitoring, echocardiography, magnetic resonance computed angiography, and percutaneous coronary angiography excluded myocardial damage. However, the close follow-up showed a steady increase of CK-MB and cTnT levels and gradual development of weakness in both thighs. A biopsy of the right quadriceps muscle led to the diagnosis of inclusion body myositis. In contrast to cTnT, cardiac troponin I could not be detected retrospectively in any of her serum samples. These results demonstrate for the first time that cTnT is elevated in patients with inclusion body myositis.
心肌肌钙蛋白T（cTnT）被认为是急性心肌梗死的特异性标志物。在此，我们报告一例经第三代检测法测定cTnT升高但无心肌损伤迹象的病例。对一名66岁惰性B细胞淋巴瘤女性患者进行的常规检查显示，尽管她没有心脏症状，但血清肌酸激酶（CK）、CK的MB同工酶（CK-MB）和cTnT水平升高。心电图监测、超声心动图、磁共振计算机血管造影和经皮冠状动脉造影均排除了心肌损伤。然而，密切随访显示CK-MB和cTnT水平持续升高，双侧大腿逐渐出现无力。右股四头肌活检确诊为包涵体肌炎。与cTnT不同，在她的任何血清样本中均未追溯检测到心肌肌钙蛋白I。这些结果首次证明包涵体肌炎患者的cTnT水平升高。
