Saunders Alexandra, Tsui Albert K Y, Alhulaimi Naji
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Department of Laboratory Medicine and Pathology, Alberta Precision Laboratories, University of Alberta, Edmonton, Alberta, Canada.
CJC Open. 2021 Mar 3;3(7):981-983. doi: 10.1016/j.cjco.2021.02.014. eCollection 2021 Jul.
A 78-year-old woman presented twice with high sensitivity troponin I (hs-TnI) elevation. Two cardiac catheterizations showed nonocclusive coronary artery disease, and 2 cardiac magnetic resonance imaging scans were normal. With these investigations unable to explain the troponin I (hs-TnI) elevation, alternate troponin samples were sent to check for assay interference. Results from these troponin assays were low. With the patient having elevated rheumatoid factor as a potential contributor to assay interference, the lab reanalyzed the samples using heterophile antibody blocking tubes, revealing lower hs-TnI levels. This case serves as a reminder to consider assay interference when the clinical picture is inconsistent with ischemia.
一名78岁女性两次出现高敏肌钙蛋白I（hs-TnI）升高。两次心脏导管检查显示为非阻塞性冠状动脉疾病，两次心脏磁共振成像扫描均正常。由于这些检查无法解释肌钙蛋白I（hs-TnI）升高的原因，于是送去其他肌钙蛋白样本以检查分析干扰情况。这些肌钙蛋白检测结果较低。鉴于该患者类风湿因子升高可能是分析干扰的一个因素，实验室使用嗜异性抗体封闭管重新分析了样本，结果显示hs-TnI水平较低。这个病例提醒我们，当临床表现与缺血情况不一致时，要考虑分析干扰因素。
