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Troponinförhöjning utan hjärtskada : En diagnostisk fallgrop vid analytisk interferens

Mahmoud, Ahmad LU orcid ; Hammarlund, Peter LU ; Ekström, Ulf LU ; Mokhtari, Arash LU ; David Dolata, Carl LU ; Engberg, Anna LU ; Svensson, Joel LU ; Bjellerup, Per and Hammarsten, Ola (2025) In Lakartidningen 123.
Abstract

High-sensitive cardiac troponins are essential biomarkers in the diagnostics of myocardial infarction. However, analytical interference such as macrotroponin, where troponin forms stable complexes with endogenous antibodies, can lead to persistently elevated levels without actual myocardial injury. The first case report presents a young woman with recurrent chest pain and prolonged troponin I elevation over several years, which ultimately could be attributed to macrotroponin I. The second case report describes a young man presenting with intermittent chest pain and stable troponin I elevation. Following extensive investigations, the elevation was ultimately attributed to macrotroponin. These cases highlight the clinical importance of... (More)

High-sensitive cardiac troponins are essential biomarkers in the diagnostics of myocardial infarction. However, analytical interference such as macrotroponin, where troponin forms stable complexes with endogenous antibodies, can lead to persistently elevated levels without actual myocardial injury. The first case report presents a young woman with recurrent chest pain and prolonged troponin I elevation over several years, which ultimately could be attributed to macrotroponin I. The second case report describes a young man presenting with intermittent chest pain and stable troponin I elevation. Following extensive investigations, the elevation was ultimately attributed to macrotroponin. These cases highlight the clinical importance of recognizing this diagnostic pitfall, especially when elevated troponin level lacks correlation with symptoms, ECG or imaging findings. In case of suspected macrotroponin, contact your local laboratory for further investigation.

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author
; ; ; ; ; ; ; and
organization
alternative title
Troponin elevation without myocardial injury - a diagnostic pitfall in cases of analytical interference
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Male, Troponin I/blood, Female, Adult, Biomarkers/blood, Chest Pain/etiology, Diagnosis, Differential, Myocardial Infarction/diagnosis
in
Lakartidningen
volume
123
publisher
Swedish Medical Association
external identifiers
  • pmid:41116727
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
d4a1511c-5f33-4e3e-90d1-62f9a047ad56
alternative location
https://media.arto.se/app/uploads/sites/11/2025/10/20100903/25107.pdf
date added to LUP
2025-10-29 13:54:18
date last changed
2025-10-29 13:54:18
@article{d4a1511c-5f33-4e3e-90d1-62f9a047ad56,
  abstract     = {{<p>High-sensitive cardiac troponins are essential biomarkers in the diagnostics of myocardial infarction. However, analytical interference such as macrotroponin, where troponin forms stable complexes with endogenous antibodies, can lead to persistently elevated levels without actual myocardial injury. The first case report presents a young woman with recurrent chest pain and prolonged troponin I elevation over several years, which ultimately could be attributed to macrotroponin I. The second case report describes a young man presenting with intermittent chest pain and stable troponin I elevation. Following extensive investigations, the elevation was ultimately attributed to macrotroponin. These cases highlight the clinical importance of recognizing this diagnostic pitfall, especially when elevated troponin level lacks correlation with symptoms, ECG or imaging findings. In case of suspected macrotroponin, contact your local laboratory for further investigation.</p>}},
  author       = {{Mahmoud, Ahmad and Hammarlund, Peter and Ekström, Ulf and Mokhtari, Arash and David Dolata, Carl and Engberg, Anna and Svensson, Joel and Bjellerup, Per and Hammarsten, Ola}},
  issn         = {{0023-7205}},
  keywords     = {{Humans; Male; Troponin I/blood; Female; Adult; Biomarkers/blood; Chest Pain/etiology; Diagnosis, Differential; Myocardial Infarction/diagnosis}},
  language     = {{swe}},
  month        = {{10}},
  publisher    = {{Swedish Medical Association}},
  series       = {{Lakartidningen}},
  title        = {{Troponinförhöjning utan hjärtskada : En diagnostisk fallgrop vid analytisk interferens}},
  url          = {{https://media.arto.se/app/uploads/sites/11/2025/10/20100903/25107.pdf}},
  volume       = {{123}},
  year         = {{2025}},
}