Millhouse James, Kamalanathan Harish, Jayasinghe Rohan
Department of Cardiology, Gold Coast University Hospital, Southport, 4215 Queensland, Australia.
Eur Heart J Case Rep. 2024 Nov 25;8(12):ytae624. doi: 10.1093/ehjcr/ytae624. eCollection 2024 Dec.
Heterophile antibody presence confounds troponin assay results, causing falsely elevated troponin levels. This rare phenomenon is an important differential to consider when evaluating patients with suspected acute coronary syndrome. We present a case series of three patients with similar clinical presentations where the presence of heterophile antibodies was confirmed.
We reviewed three patients from our hospital who presented with chest pain in a 12-month period. All patients were males aged 50-70. All patients had elevated troponin, and there was clinical concern for acute coronary syndrome in two patients. Two patients underwent coronary angiography during admission, and the third had a recent angiogram within the last 6 months. No obstructive lesions were found, and no alternative diagnoses were identified. Ultimately, the presence of heterophile antibodies was confirmed in all three patients.
Heterophile antibody presence is an important differential to consider in patients with unexplained troponin elevation. Once the presence of heterophile antibodies is confirmed, this aids in clinician decision-making and helps to guide investigations and treatment in future.
嗜异性抗体的存在会干扰肌钙蛋白检测结果，导致肌钙蛋白水平假性升高。这种罕见现象是评估疑似急性冠状动脉综合征患者时需要考虑的重要鉴别因素。我们报告了一系列三例临床表现相似且已证实存在嗜异性抗体的病例。
我们回顾了我院在12个月内出现胸痛症状的三名患者。所有患者均为50 - 70岁男性。所有患者的肌钙蛋白均升高，其中两名患者临床上怀疑患有急性冠状动脉综合征。两名患者在入院期间接受了冠状动脉造影，第三名患者在过去6个月内近期进行过血管造影。未发现阻塞性病变，也未确定其他诊断。最终，所有三名患者均被证实存在嗜异性抗体。
对于肌钙蛋白不明原因升高的患者，嗜异性抗体的存在是一个需要考虑的重要鉴别因素。一旦证实存在嗜异性抗体，这有助于临床医生进行决策，并有助于指导未来的检查和治疗。
