[Significance of serum troponin T in the differential diagnosis of myocardial infarct vs rhabdomyolysis vs renal insufficiency].
METHODS
A 30-year-old man in renal failure due to focal sclerosing glomerulonephritis was, after a seizure with subsequent rhabdomyolysis, found to have an increase not only of creatinekinase (CK) activity (> 100,000 U/l) but also of cardiac troponin T (cTnT) concentration in serum (13 micrograms/l; normal: < 0.1 microgram/l), in the absence of any cardiac symptoms.


RESULTS
Raised concentration of cTnT is known to occur in patients with renal failure but no cardiac symptoms. In our patient, despite increased creatinine levels, serum cTnT gradually fell to normal within 3 weeks, i.e. the raised creatinine played no part in the elevation of cTnT, which in this patient was probably due to crossreaction between cardiac and skeletal TnT, or transient fresh synthesis of cTnT in regenerating skeletal musculature.


CONCLUSIONS
In patients with extensive rhabdomyolysis and renal failure the assessment of the clinical status and the ECG, to exclude myocardial infarction, are of crucial importance. The cTnT level by itself is of only limited value in such cases.
Bertsch
T
T
Institut für Klinische Chemie, Universität Heidelberg.
Resch
S
S
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis*; D051437:Renal Insufficiency / Q000175:diagnosis*; D012206:Rhabdomyolysis / Q000175:diagnosis*; D014336:Troponin / Q000097:blood*; D020107:Troponin T
D015415:Biomarkers; D014336:Troponin; D020107:Troponin T