Open AccessFalse-positive Troponin I Assay Elevation Due to Occult Mixed Cryoglobulinemic Vasculitis
Author(s) -
Mazen Odish,
Tomasz Beben,
Lori B. Daniels
Publication year - 2018
Publication title -
reviews in cardiovascular medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.555
H-Index - 39
eISSN - 2153-8174
pISSN - 1530-6550
DOI - 10.31083/j.rcm.2018.02.902
Subject(s) - medicine , rheumatoid factor , vasculitis , troponin , cardiology , gastroenterology , occult , cryoglobulinemia , rheumatoid arthritis , immunology , pathology , hepatitis c virus , myocardial infarction , alternative medicine , disease , virus
A 53-year-old man with active hepatitis C and cirrhosis presented with a vasculitic rash, myalgias, and fatigue, and was found to have an elevated cardiac troponin I up to 15.7 ng/mL with normal electrocardiogram, echocardiogram, and coronary angiogram prior to being discharged. Subsequently, during a similar presentation to another academically affiliated hospital, the patient had a normal cardiac troponin T (< 0.01 ng/mL). Upon his third presentation with significantly elevated troponin I to 15.98 ng/mL, the patient was found to have cryoglobulinemic vasculitis and elevated rheumatoid factor due to active hepatitis C, causing interference with the troponin I immunoassay. In conclusion, troponin I assays may have high false-positive values due to interference by rheumatoid factor and/or a polyclonal antibody found in cryoglobulinemia.