Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?
Abstract A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14360 |
| _version_ | 1797770721747795968 |
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| author | Valentina A. Rossi Joanna Gawinecka Florentia Dimitriou Arnold vonEckardstein Reinhard Dummer Frank Ruschitzka Christian M. Matter |
| author_facet | Valentina A. Rossi Joanna Gawinecka Florentia Dimitriou Arnold vonEckardstein Reinhard Dummer Frank Ruschitzka Christian M. Matter |
| author_sort | Valentina A. Rossi |
| collection | DOAJ |
| description | Abstract A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was based on the typical time window after ICI, recurrence upon re‐challenge, elevations of CK, high‐sensitive troponin T (hs‐TnT) and I (hs‐TnI), mild NT‐proBNP increase, and positive magnetic resonance imaging criteria. Notably, hsTnI was found to more rapidly increase and fall and to be more heart‐specific than TnT in the context of ICI‐related myocarditis. This led to ICI therapy withdrawal and switch to a less effective systemic therapy. This case report highlights the differential value of hs‐TnT and hs‐TnI for diagnosis and monitoring of ICI‐related myositis and myocarditis. |
| first_indexed | 2024-03-12T21:27:18Z |
| format | Article |
| id | doaj.art-1854f092132e434f9381d0bc3fe6863b |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-12T21:27:18Z |
| publishDate | 2023-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-1854f092132e434f9381d0bc3fe6863b2023-07-28T06:30:48ZengWileyESC Heart Failure2055-58222023-08-011042680268510.1002/ehf2.14360Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?Valentina A. Rossi0Joanna Gawinecka1Florentia Dimitriou2Arnold vonEckardstein3Reinhard Dummer4Frank Ruschitzka5Christian M. Matter6Department of Cardiology, University Heart Center University Hospital Zurich Zurich SwitzerlandInstitute of Clinical Chemistry University Hospital Zurich and University of Zurich Zurich SwitzerlandDepartment of Dermatology University Hospital Zurich Zurich SwitzerlandInstitute of Clinical Chemistry University Hospital Zurich and University of Zurich Zurich SwitzerlandDepartment of Dermatology University Hospital Zurich Zurich SwitzerlandDepartment of Cardiology, University Heart Center University Hospital Zurich Zurich SwitzerlandDepartment of Cardiology, University Heart Center University Hospital Zurich Zurich SwitzerlandAbstract A 54‐year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti‐programmed cell death receptor‐1, anti‐lymphocyte activating gene‐3, and anti‐indoleamine 2,3‐dioxygenase‐1). The diagnosis was based on the typical time window after ICI, recurrence upon re‐challenge, elevations of CK, high‐sensitive troponin T (hs‐TnT) and I (hs‐TnI), mild NT‐proBNP increase, and positive magnetic resonance imaging criteria. Notably, hsTnI was found to more rapidly increase and fall and to be more heart‐specific than TnT in the context of ICI‐related myocarditis. This led to ICI therapy withdrawal and switch to a less effective systemic therapy. This case report highlights the differential value of hs‐TnT and hs‐TnI for diagnosis and monitoring of ICI‐related myositis and myocarditis.https://doi.org/10.1002/ehf2.14360MyocarditisMyositisImmune checkpoint inhibitorTroponin |
| spellingShingle | Valentina A. Rossi Joanna Gawinecka Florentia Dimitriou Arnold vonEckardstein Reinhard Dummer Frank Ruschitzka Christian M. Matter Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? ESC Heart Failure Myocarditis Myositis Immune checkpoint inhibitor Troponin |
| title | Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? |
| title_full | Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? |
| title_fullStr | Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? |
| title_full_unstemmed | Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? |
| title_short | Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge? |
| title_sort | value of troponin t versus i in the diagnosis of immune checkpoint inhibitor related myocarditis and myositis rechallenge |
| topic | Myocarditis Myositis Immune checkpoint inhibitor Troponin |
| url | https://doi.org/10.1002/ehf2.14360 |
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