Lakusic Nenad, Sopek Merkas Ivana, Lucinger Daren, Mahovic Darija
Department of Cardiology, Special Hospital for Medical Rehabilitation Krapinske Toplice, Croatia.
Department of Clinical Medicine, Faculty of Dental Medicine and Health Osijek, J. J. Strossmayer University of Osijek, Croatia.
Eur Heart J Case Rep. 2021 Feb 4;5(2):ytab018. doi: 10.1093/ehjcr/ytab018. eCollection 2021 Feb.
Heterophile antibodies are one of the most common causes of false-positive troponin.
We report a case of a 53-year-old woman with false-positive troponin elevation and a clinical presentation understood and treated as non-ST-elevation acute coronary syndrome. Because of chronic basal elevation of troponin (at a 'plateau' level) and chest pain, the patient underwent several invasive coronary angiograms until false-positive increase of troponin due to heterophile antibodies was suspected. Borderline stenosis of a left circumflex coronary artery found on first coronary angiogram was a coincidental finding and heterophile antibodies in the patient's serum were confirmed.
This interesting case report aims to remind the clinicians about the possibility of false-positive troponin level due to laboratory analytical interference caused by heterophile antibodies. In this case, it is important to suspect false-positive troponin elevation, even when coronary artery disease is found. This rare and less mentioned and/or recognized cause of troponin elevation may lead to unnecessary invasive diagnostics and aggressive treatment of patients.
嗜异性抗体是肌钙蛋白假阳性最常见的原因之一。
我们报告一例53岁女性，其肌钙蛋白升高呈假阳性，临床表现被理解为非ST段抬高型急性冠状动脉综合征并接受了相应治疗。由于肌钙蛋白长期处于基础升高水平（处于“平台期”）且伴有胸痛，该患者接受了多次有创冠状动脉造影，直到怀疑肌钙蛋白的假阳性升高是由嗜异性抗体引起的。首次冠状动脉造影发现左旋支冠状动脉有临界狭窄，这是一个偶然发现，患者血清中的嗜异性抗体得到了证实。
这份有趣的病例报告旨在提醒临床医生，嗜异性抗体引起的实验室分析干扰可能导致肌钙蛋白水平出现假阳性。在这种情况下，即使发现了冠状动脉疾病，怀疑肌钙蛋白升高为假阳性也很重要。这种导致肌钙蛋白升高的罕见且较少被提及和/或认识到的原因可能会导致对患者进行不必要的有创诊断和积极治疗。
