In message <[log in to unmask]>, Dr. T.A. Gray
<[log in to unmask]> writes
>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
You do not include any cTnT values so it is impossible to judge!!!
However, at this level of CK cTnT would be undetectable if non cardiac
This looks more like an MI (from the CK-MB) although we do have 1 case of
polymyosistis with cardiac involvement.
--
Paul Collinson
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