[Interpretation of elevated serum troponin levels in end stage renal disease - case 2/2010].
METHODS
We report on a female patient with rheumatoid arthritis and end-stage renal-disease following AA-amyloidosis who presented with chest pain to the emergency department.


METHODS
ECG showed no signs of ischemia, echocardiography revealed a concentric left ventricular hypertrophy with increased texture. Serum concentration of troponin I was mildly elevated whereas creatine kinase (CK)/ CK-MB were normal.


METHODS
The chief complaints resolved spontaneously and there was no change in the serum troponin-I and CK/CK-MB concentrations. Coronary heart disease was ruled out by angiography and cardiac involvement of the underlying AA-amyloidosis was diagnosed. After one month, the patient suffered from a syncope complicated by a pelvic ring fracture with hemorrhagic shock and declined chronic dialysis treatment.


CONCLUSIONS
Patients with end-stage renal disease may exhibit a persisting elevation of serum troponin concentration reflecting the high burden of cardiovascular disease. Myocardial infarction can be distinguished by the lack of increase in serial tests.
Artunc
Ferruh
F
Medizinische Universitätsklinik Tübingen, Abteilung für Endokrinologie, Diabetologie, Nephrologie, Angiologie und Klinische Chemie. ferruh.artunc@med.uni-tuebingen.de
Haap
Michael
M
Heyne
Nils
N
Weyrich
Peter
P
Wolf
Sabine
S
D000686:Amyloidosis / Q000097:blood* / Q000175:diagnosis; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis; D009202:Cardiomyopathies / Q000097:blood* / Q000175:diagnosis; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D000685:Serum Amyloid A Protein / Q000378:metabolism*; D019210:Troponin I / Q000097:blood*
D000685:Serum Amyloid A Protein; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form