Dear Trevor
It will be helpful if you gave us serial measurements
of CK, CKMB mass and TnT over 3-4 days.
Polymyositis produce persistent elevation of CK, even
if there is a concomitant AMI, the cardiac specific
markers should show the typical temporal release
kinetics if the myocardial damage is due to a coronary
occlusion. However if the myocardial damage is due to
immunological myositis with myocardial involvement the
cardiac specific markers may show persistent
elevation.
regards.
--- Trevor Gray <[log in to unmask]> wrote:
> Dear Colleagues
>
> Sorry about the missing Troponin T level - 3.58
> ug/L.
>
> The only paper I can find is an old Lancet letter
> from around 1992,
> which presumably used the older TropT assay. Levels
> in dermatomyositis
> and polymyositis patients averaged 4-5 ug/L. As in
> this patient, there
> were no signs of cardiac disease in most of the
> patients. It was assumed
> that this was evidence for a more widespread cardiac
> component to the
> disease than generally recognised. Given our more
> recent understanding,
> is that still the case or does the raised TropT in
> polymyositis
> represent the regenerating muscle which has the
> potential to produce
> TropT (as in the 1997 clin chem paper). The level
> in our patient would
> be unlikely to be clinically silent, in my
> experience, if it represented
> cardiac damage post MI.
>
> So, with apologies for missing the vital figure !,
> has anyone any
> experience of TropT levels in polymyositis and what
> do they mean ?
> Trevor
> --
> Trevor Gray
> Dept. of Clinical Chemistry,
> Northern General Hospital,
> Sheffield S5 7AU
>
> 0114 271 4309
=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
Whiston Hospital
Prescot
Merseyside L35 5DR
UK
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