Bajwa Omer, Hassen Gashaw, Fishbein Jacob, Uchenna Unamba, Ammar Hussam
Internal Medicine, University of Maryland Capital Region Medical Center, Maryland, USA.
Cureus. 2023 Jan 25;15(1):e34186. doi: 10.7759/cureus.34186. eCollection 2023 Jan.
Falsely elevated troponin has been reported in the literature. The authors present a case of a 51-year-old man who was admitted with nausea, vomiting, and chest discomfort. He was found to have elevated troponin with no electrocardiographic changes. He has normal coronaries on angiogram and normal echocardiogram. A diagnostic time-out and second look at the laboratory values captured abnormalities that triggered a workup that ruled in a multiple myeloma diagnosis. We suspected falsely elevated troponin levels secondary to macrotroponin, a complex of elevated immunoglobulin levels and troponin, which has been rarely reported to cause elevated troponin levels in patients with multiple myeloma.
文献中已报道过肌钙蛋白假性升高的情况。作者报告了一例51岁男性病例，该患者因恶心、呕吐和胸部不适入院。他被发现肌钙蛋白升高，但心电图无变化。其血管造影显示冠状动脉正常，超声心动图也正常。经过一次诊断暂停并再次查看实验室值后，发现了异常情况，进而展开检查，最终确诊为多发性骨髓瘤。我们怀疑肌钙蛋白水平假性升高是由巨肌钙蛋白引起的，巨肌钙蛋白是免疫球蛋白水平升高与肌钙蛋白形成的复合物，在多发性骨髓瘤患者中很少报道会导致肌钙蛋白水平升高。
