We have a 71 year old man with a previous history of a MI 4 years ago who
has had multiple acute admissions with chest pain. He has recently been
admitted for the twelfth time in the last two years. Invariably(and
unusually) the admission CK levels have been highest and have varied between
300 - 900 IU/L with a clear temporal fall over 12 -24 hours. In every case
the Troponin I (Bayer) has been undetectable. The admission CRP levels
have mainly been <1.0 mg/L with normal lipid profile, glucose and TSH
levels. The Al-T level has varied between 42 - 100 IU/L.
The clinical/ECG picture suggests ACS, although biochemically all these
episodes appear to indicate skeletal muscle damage, which is rather
surprising given his clinical history. Is it possible to get falsely normal
Troponin results due to assay interference, or could there be another
explanation? Any thoughts would be most most appreciated.
With many thanks,
Roy Fisher
Royal Cornwall Hospital
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