Heterophilic Antibody Interference with CARDIAC T Quantitative Rapid Assay

摘要

Point-of-care troponin assays are promoted as providing rapid, reliable results to support best practice management of acute chest pain (1). We report a case of false-positive cardiac troponin T (cTnT) results that caused inappropriate clinical management.A 46-year-old man consulted his general practitioner after 10 h of central chest pain and tingling in the left arm after a heavy fall. An electrocardiogram showed possible ST elevation. A repeat electrocardiogram in the local hospital showed sinus rhythm and an early repolarization pattern. Whole-blood cTnT (lithium heparinate) was increased both on admission and the next day in a CARDIAC T Quantitative Rapid Assay (third generation; Roche Diagnostics). The patient was a moderately heavy smoker, was mildly hypercholesterolemic, and had a family history of ischemic heart disease. The patient was transferred to the tertiary hospital where a coronary angiogram and plasma (lithium heparinate) cTnT (T STAT, third generation; Roche Diagnostics) were normal (Table 1? ). Creatine kinase and lactate dehydrogenase concentrations in the two samples taken at the local hospital and two samples taken at the tertiary hospital were within the appropriate reference intervals (data not shown). The patient was diagnosed with presumed musculoskeletal chest pain.View this table: Table 1. cTnT results obtained by the CARDIAC T Quantitative Rapid and Troponin T STAT methods.The CARDIAC T sandwich assay uses a test strip and two murine monoclonal antibodies to human cTnT. A reader records the intensity of the reflectance … [?][1]bAddress correspondence to this author at: Roche Diagnostics GmbH, Evaluation, Primary and Cardiac Care (Department DD-EN), Sandhofer Strasse 116, D-68163 Mannheim, Germany. [1]: #xref-corresp-2-1