Mahalingam M, Ottlinger M E
Mallory Institute of Pathology, Boston, MA 02118, USA.
J Clin Pathol. 1996 Sep;49(9):766-7. doi: 10.1136/jcp.49.9.766.
A case of a spurious rise in cardiac troponin-T in an 85 year old Caucasian man with myelodysplastic syndrome and multiple malignancies but with intact cardiac and renal function is reported. The patient presented to the accident and emergency department with fever and chest pain. Inconsistent laboratory findings in biochemical markers diagnostic of myocardial infarction were observed. Discrepant findings included a rise in the concentration of the cardiac specific marker troponin-T in the absence of an increase in creatine kinase (CK) isoenzyme MB activity. Somewhat surprisingly, there was a significant and consistent increase in CK isoenzyme BB activity. Awareness of the increase in troponin-T concentrations in patients with multiple clinical non-cardiac problems may prevent an erroneous diagnosis of myocardial infarction and avert institution of unduly aggressive treatment.
报告了一例85岁患有骨髓增生异常综合征和多种恶性肿瘤但心脏和肾功能正常的白种男性患者，其心肌肌钙蛋白T出现假性升高的病例。该患者因发热和胸痛就诊于急诊科。观察到诊断心肌梗死的生化标志物存在不一致的实验室检查结果。不一致的发现包括在肌酸激酶（CK）同工酶MB活性未增加的情况下，心脏特异性标志物肌钙蛋白T的浓度升高。有点令人惊讶的是，CK同工酶BB活性有显著且持续的升高。认识到患有多种临床非心脏问题的患者肌钙蛋白T浓度升高，可能会防止对心肌梗死的错误诊断，并避免采取过度积极的治疗措施。
