Identification of macrotroponin T: findings from a case report and non-reproducible troponin T results
| Autor: | Leo Lam, Campbell Kyle, Campbell Le Heron, Leah Ha, Weldon Chiu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Clinical Biochemistry Gastroenterology law.invention Troponin complex Troponin T law Internal medicine Troponin I Medicine Humans Clinical significance Autoantibodies biology business.industry Biochemistry (medical) Autoantibody General Medicine Mixing study biology.protein Recombinant DNA Biological Assay Antibody business Biomarkers |
| Zdroj: | Clinical chemistry and laboratory medicineReferences. 59(12) |
| ISSN: | 1437-4331 |
| Popis: | Objectives Macrotroponin is due to cardiac troponin (cTn) binding to endogenous cTn autoantibodies. While previous studies showed a high incidence of macrotroponin affecting cTnI assays, reports of macrotroponin T, particularly without cTnI reactivity, have been rare. Although the clinical significance of macrotroponin is not fully understood, macroenzymes and complexes are recognised to cause confusion in interpretation of laboratory results. The potential for adverse clinical consequences due to misinterpretation of affected results is very high. Methods We describe four cases of macrotroponin T with persistently low high sensitivity cTnT (hs-cTnT) by the 9 min compared to the 18 min variant of the assay. Three cases were serendipitously identified due to the use of a lot number of Roche hs-cTnT affected by non-reproducible results, necessitating measurement of cTnT in duplicate. We identified and characterised these macrotroponin specimens by immunoglobulin depletion (Protein A and PEG precipitation), mixing studies with EDTA and recombinant cTnT. Results In cases of macro-cTnT, a lower result occurred on the hs-cTnT using the 9 min compared to 18 min variant assay (ratio of 9–18 min hs-cTnT Conclusions We identified several cases of macro-cTnT and described associated clinical and biochemical features. |
| Databáze: | OpenAIRE |
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