On Wed, 20 Mar 2002 17:04:52 -0000, Firth, Gary <gary.firth@MID-
SUSSEX.STHAMES.NHS.UK> wrote:
>Whilst putting together a presentation on troponin T for our medical staff
I
>have come across several papers that indicate that Troponin T (but rarely
I)
>is raised in some cases of polymyositis and dermatomyositis.
>The suggestion made in at least one paper (Clin Chim Acta 2001; 306:27) is
>that this may be due to release of cTnT from skeletal muscle. Does anyone
>have any evidence to support or refute this suggestion or is this indeed
the
>exception that proves the rule?
>Gary Firth
>Princess Royal Hospital
>Sussex
>
We routinely measure cTnT on all our dermatomyositis patients when
attending the clinic, and find that the marker is usually raised. We
monitored one patient for a time, and concluded that cTnT reflected
myocardial damage during the active phase of the disease (Clin Chem
2001;47:1130-1).
Listed below are some useful references for cardiac involvement in
polymyositis/dermatomyositis due to generalised fibrosis and microvascular
damage, including non-ischaemic infarction.
Deswall A. Cardiac involvement in scleroderma. Rheum Dis Clin NA
1996;22:841-60.
Buchpiguel CA et al. Cardiac and skeletal muscle scintigraphy in dermato-
and polymyositis.: clinical implications. Eur J Nucl Med 1996;23:199-203.
Lie JT. Cardiac manifestations in polymyositis/dermatomyositis: how to get
to the heart of the matter. J Rheumatol 1995;22:808-11.
Anders H-J et al. Myocardial fibrosis in polymyositis. J Rheumatol
1999;26:1840-2.
Gonzalez-Lopez L et al. Cardiac manifestations in dermatopolymyositis. Clin
Exp Rheumatol 1996;14:373-9.
Badui E et al. Acute myocardial infarction with normal coronary arteries in
a patient with dermatomyositis. Angiology 1996;47:815-8.
Riemekasten G et al. Beware of the heart: the multiple picture of cardiac
involvement in myositis. Rheumatol 1999;38:1153-7.
Kobayashi S et al. Serum cardiac troponin T in
polymyositis/dermatomyositis. Lancet 1992;340:726.
Erlacher P et al. Cardiac troponins and beta-type cardiac myosin heavy
chain concentrations in patients with polymyositis and dermatomyositis.
Clin chem 2000;46:A78.
White et al. Dermatomyositis - a cause of elevated troponin T (cTnT). Clin
Chem 2000;46:A82.
White et al. Increased Troponin T in a patient with dermatomyositis. Clin
Chem 2001;47:1130-1.
Hope this helps
Graham White
Flinders Medical Centre
Bedford Park
South Australia.
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