Persistently elevated CKMB and negative troponin T in a patient at ischaemic risk with chest pain.
Analytical interference in laboratory assays is not only unpredictable but also an underestimated problem. Not recognising these interferences can lead to misdiagnosis and mismanagement of patients. We present a case of a patient with chest pain and ischaemic risk factors with incongruent biochemical results. These results were discovered to be due to the presence of macro-creatine kinase (macro-CK) in vivo interfering with the CKMB activity assay.
Schulenburg
D
D
Department of Chemical Pathology, Universitas National Health Laboratory Services, University of the Free State, Bloemfontein, South Africa.
De Lange
W
W
Van Jaarsveld
H
H
Kuyl
J M
JM
D016477:Artifacts; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood / Q000209:etiology*; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013997:Time Factors; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation
D015415:Biomarkers; D020107:Troponin T; D052279:Creatine Kinase, MB Form