Positive troponin T without cardiac involvement in inclusion body myositis.
Cardiac troponin T (cTnT) is considered as a specific marker for acute myocardial infarction. Here, we present a case with elevated cTnT, determined by a third-generation assay, without signs of a myocardial lesion. Routine investigation of a 66-year-old female patient with indolent B-cell lymphoma revealed increased serum levels of creatine kinase (CK), MB fraction of CK (CK-MB), and cTnT, although she did not complain of cardiac symptoms. Electrocardiographic monitoring, echocardiography, magnetic resonance computed angiography, and percutaneous coronary angiography excluded myocardial damage. However, the close follow-up showed a steady increase of CK-MB and cTnT levels and gradual development of weakness in both thighs. A biopsy of the right quadriceps muscle led to the diagnosis of inclusion body myositis. In contrast to cTnT, cardiac troponin I could not be detected retrospectively in any of her serum samples. These results demonstrate for the first time that cTnT is elevated in patients with inclusion body myositis.
Schwarzmeier
Josef D
JD
Hematology Department, Internal Medicine I, Medical University of Vienna, A-1097 Vienna, Austria. josef.schwarzmeier@meduniwien.ac.at
Hamwi
Ahmad
A
Preisel
Martin
M
Resl
Christoph
C
Preusser
Matthias
M
Sluga
Elfriede
E
Horcher
Ernst
E
Shehata
Medhat M
MM
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications; D018482:Muscle, Skeletal / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D018979:Myositis, Inclusion Body / Q000097:blood* / Q000150:complications; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T; D003402:Creatine Kinase