Elevated troponin levels associated with hemolysis.
A 75-year-old African American man with a history of gastroesophageal reflux reported chest pain during an episode of intravascular hemolysis. Although the electrocardiogram and echocardiogram were unchanged from baseline, cardiac troponin I was persistently elevated. Cardiac catheterization showed no critical disease, and the elevated troponin was attributed to interference by free hemoglobin and/or bilirubin. Hemoglobinemia and hyperbilirubinemia may produce either false-positive or false-negative troponin levels, depending on the assay used and the form or subunit of troponin measured. In the presence of hemolysis, troponin levels must be interpreted with caution.
Masimasi
Nziavake
N
Medical Service and Hematology/Oncology Division, VA Medical Center, Lexington, KY 40502, USA.
Means
Robert T
RT
D000368:Aged; D001663:Bilirubin / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D008297:Male; D009206:Myocardium / Q000378:metabolism; D019210:Troponin I / Q000097:blood*
D006454:Hemoglobins; D019210:Troponin I; D001663:Bilirubin