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False-Negative Qualitative Troponin T
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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To the Editor.Dr Mahalingam and Ottlinger1 report the case of an elderly patient with angina pectoris on exertion associated with discrepancies in laboratory values comprising an increase in quantitative cardiac troponin T (cTnT) and in total and MB creatine kinase (CK) and a negative result for cTnT rapid test. They conclude that the cTnT rapid test failed to diagnose myocardial infarction in this patient. However, we propose another hypothesis: that the patient had no myocardial infarction but only a macro CK in his serum.
Macro CK is an abnormal CK isoenzyme found in approximately 1% of patients tested for CK.2 Type 1 macro CK may result from aggregates of monoclonal IgG and is reported to be associated with autoimmune diseases. Type 2 macro CK may be associated with neoplastic diseases. Macro CK may be responsible for an increased plasma concentration of total and MB CK when these parameters are . . . [Full Text of this Article]
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