BACKGROUND: Careful interpretation of discordant results in high-sensitivity troponin measurements is necessary in cases of suspect immunoassay interferences. We describe several procedures taken in a case of a polymorbid patient with chest pain, without clear evidence of myocardial necrosis and with increased high-sensitivity cardiac troponin T (hs-cTnT). We checked the Vafaie's algorithm for the evaluation of suspect interference in troponin measurements. METHODS: We conducted a case report analysis, additional measurements, a dilution test and pretreatment of plasma with blocking agents. RESULTS: Concentration of hs-cTnT (99 th percentile of "healthy" population 14 ng/L) increased from 120.1 ng/L to 280.4 ng/L during an 8-month period and decreased to 216.3 ng/L during the following month with repeatedly negative troponin I (TnI), hs-cTnI, myoglobin and creatine kinase MB (CK-MB). Suspected false positivity of hs-cTnT was further confirmed by treatment of plasma with an antiheterophile blocking agent (hs-cTnT before treatment 280.4 ng/L, after 16.53/16.23 ng/L). This outcome was further confirmed by the manufacturer's experiments. CONCLUSIONS: The false-positive results of hs-cTnT were caused by the presence of extremely rare high molecular weight protein, presumably IgM, most likely HAMA (human anti-mouse antibody). Only the pre-treatment of plasma with a blocking agent provided a reliable indication of the interference. Cooperation among clinicians, laboratory personnel and the manufacturer is essential.

• MeSH
• blokáda Tawarova raménka krev   komplikace   patologie   MeSH
• bolesti na hrudi krev   komplikace   patologie   MeSH
• bolesti zad krev   komplikace   patologie   MeSH
• diabetes mellitus 2. typu krev   komplikace   patologie   MeSH
• dyslipidemie krev   komplikace   patologie   MeSH
• falešně pozitivní reakce MeSH
• hypertenze krev   komplikace   patologie   MeSH
• imunoanalýza MeSH
• imunoglobulin M krev   MeSH
• lidé MeSH
• monoklonální protilátky chemie   MeSH
• myši MeSH
• osteoporóza krev   komplikace   patologie   MeSH
• referenční hodnoty MeSH
• senioři MeSH
• troponin I krev   MeSH
• troponin T krev   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• senioři MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH