False-positive Troponin I Assay elevation due to occult Mixed Cryoglobulinemic Vasculitis.
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.
['Odish|Mazen|M|', 'Beben|Tomasz|T|', 'Daniels|Lori B|LB|']
D015415:Biomarkers D003449:Cryoglobulinemia D003951:Diagnostic Errors D005189:False Positive Reactions D006331:Heart Diseases D006526:Hepatitis C D006801:Humans D007118:Immunoassay D008104:Liver Cirrhosis, Alcoholic D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D012217:Rheumatoid Factor D019210:Troponin I D015854:Up-Regulation D014657:Vasculitis
troponin cryoglobulinemia Biomarkers acute coronary syndrome