“Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report
Cardiac troponins are key diagnostic and prognostic biomarkers in acute myocardial infarction and, more generally, for the detection of myocardial injury. Since the introduction of the first immunochemistry methods, there has been a remarkable evolution in analytical performance, especially concerni...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/10/9/378 |
| _version_ | 1797579538797953024 |
|---|---|
| author | Davide Bosi Simone Canovi Andrea Pennacchioni Pierluigi Demola Mattia Corradini Vincenzo Guiducci Rossana Colla Alessandro Navazio |
| author_facet | Davide Bosi Simone Canovi Andrea Pennacchioni Pierluigi Demola Mattia Corradini Vincenzo Guiducci Rossana Colla Alessandro Navazio |
| author_sort | Davide Bosi |
| collection | DOAJ |
| description | Cardiac troponins are key diagnostic and prognostic biomarkers in acute myocardial infarction and, more generally, for the detection of myocardial injury. Since the introduction of the first immunochemistry methods, there has been a remarkable evolution in analytical performance, especially concerning a progressive improvement in sensitivity. However, the measurement of circulating troponins remains rarely susceptible to analytical interferences. We report a case of persistently elevated troponin I concentrations in a patient with known ischemic heart disease, which almost led to unnecessary diagnostic–therapeutic interventions. A prompt laboratory consultation by the cardiologist ultimately led to the identification of an analytical interference due to troponin macrocomplexes (macrotroponin) causing elevated troponin values in the absence of a clinical presentation compatible with myocardial damage. |
| first_indexed | 2024-03-10T22:38:33Z |
| format | Article |
| id | doaj.art-bb5f1020a4c540bc92c68b0c1e2c625c |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-10T22:38:33Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-bb5f1020a4c540bc92c68b0c1e2c625c2023-11-19T11:16:35ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-09-0110937810.3390/jcdd10090378“Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case ReportDavide Bosi0Simone Canovi1Andrea Pennacchioni2Pierluigi Demola3Mattia Corradini4Vincenzo Guiducci5Rossana Colla6Alessandro Navazio7Cardiology Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyClinical Laboratory Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyCardiology Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyCardiology Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyClinical Laboratory Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyCardiology Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyClinical Laboratory Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyCardiology Unit, AUSL—IRCCS di Reggio Emilia, 42100 Reggio Emilia, ItalyCardiac troponins are key diagnostic and prognostic biomarkers in acute myocardial infarction and, more generally, for the detection of myocardial injury. Since the introduction of the first immunochemistry methods, there has been a remarkable evolution in analytical performance, especially concerning a progressive improvement in sensitivity. However, the measurement of circulating troponins remains rarely susceptible to analytical interferences. We report a case of persistently elevated troponin I concentrations in a patient with known ischemic heart disease, which almost led to unnecessary diagnostic–therapeutic interventions. A prompt laboratory consultation by the cardiologist ultimately led to the identification of an analytical interference due to troponin macrocomplexes (macrotroponin) causing elevated troponin values in the absence of a clinical presentation compatible with myocardial damage.https://www.mdpi.com/2308-3425/10/9/378high-sensitivity troponinacute coronary syndromeimmunoglobulinlaboratory testsanalytic interference |
| spellingShingle | Davide Bosi Simone Canovi Andrea Pennacchioni Pierluigi Demola Mattia Corradini Vincenzo Guiducci Rossana Colla Alessandro Navazio “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report Journal of Cardiovascular Development and Disease high-sensitivity troponin acute coronary syndrome immunoglobulin laboratory tests analytic interference |
| title | “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report |
| title_full | “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report |
| title_fullStr | “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report |
| title_full_unstemmed | “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report |
| title_short | “Troponinosis”, the Cardiologist’s Curse—When Clinic–Laboratory Interaction Unveils the Mystery: A Case Report |
| title_sort | troponinosis the cardiologist s curse when clinic laboratory interaction unveils the mystery a case report |
| topic | high-sensitivity troponin acute coronary syndrome immunoglobulin laboratory tests analytic interference |
| url | https://www.mdpi.com/2308-3425/10/9/378 |
| work_keys_str_mv | AT davidebosi troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT simonecanovi troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT andreapennacchioni troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT pierluigidemola troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT mattiacorradini troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT vincenzoguiducci troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT rossanacolla troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport AT alessandronavazio troponinosisthecardiologistscursewhencliniclaboratoryinteractionunveilsthemysteryacasereport |