类风湿因子升高情况下肌钙蛋白持续升高：何时值得再次检查。
Persistent Troponin Elevation in the Setting of an Elevated Rheumatoid Factor: When It Pays to Double Check.
作者信息
Saunders Alexandra, Tsui Albert K Y, Alhulaimi Naji
机构信息
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Department of Laboratory Medicine and Pathology, Alberta Precision Laboratories, University of Alberta, Edmonton, Alberta, Canada.
出版信息
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。
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