Dear colleagues
I would value your collective experience of Troponin T in patients
without MI. We have a 75 year old lady on GITU who presented with
rapidly progressive muscular weakness. This occurred after minor
illness which has raised the possibility of Guillain Barre Disease.
However her CK was 1323 IU/L, CKMB mass 582.6 ug/L and Troponin T ug/L
(Roche 2010) so the neurologists favour polymyositis. There is no
clinical or ecg evidence of MI but her CK and CKMB mass has declined in
a similar manner to post MI.
She has pressure sores from lying weak in bed which could also account
for the CK (but not the CKMB mass) but the question asked by our
neurologists was whether this level of TropT was ever seen from
regenerating muscle in polymyositis. Certainly the level appears high
for the CK just to be from a MI, but I have not seen any literature on
the actual levels achieved in polymyositis although I know there is the
theroetical possibility of TropT being formed in regenerating muscle.
Her renal function is normal as is most of the rest of her biochemistry.
Trevor
Dr. T.A. Gray
Department of Clinical Chemistry
Northern General Hospital
Sheffield S5 7AU
0114 271 4309
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