Hi Pullan,
Troponin elevations may reflect myocardial injury that is not necessarily due to an acute coronary syndrome (ACS).
Troponin is not as specific as it thought off.
Increased blood concentrations of troponin can also be seen in a variety of other diseases, such as
Non-cardiac-related causes of Troponin elevation;
- Rhabdomyolysis (with hydration, the cornerstone of the treatment of rhabdomyolysis, troponin levels revert to normal.)
- coronary artery spams from cocaine,
- sepsis,
- hypovolemia,
- renal failure (indicates a long-term risk of death of it stays elevated).
Cardiac-related;
- atrial fibrillation,
- heart failure,
- pulmonary embolism,
- myocarditis,
- myocardial contusion, and
Do have additional data / info to rule-in on any of the non-cardiac-related causes of elevated troponin?
Thank you
Chesinta Voma, PhD
University of Louisville
School of Medicine
Department of Pathology & Laboratory Medicine
Clinical Chemistry Fellowship
Psalms 7:10. "My defense is of God who saves the upright in heart".
--------------------------------------------
On Fri, 4/8/16, Pullan Nicola (ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST) <[log in to unmask]> wrote:
Subject: Re: Elevated Trop T necrotic pancreatis
To: [log in to unmask]
Date: Friday, April 8, 2016, 7:30 AM
Forgot to say: the
patient is a 36 yo male.
From: Clinical biochemistry discussion
list [mailto:[log in to unmask]]
On Behalf Of Pullan Nicola (ROYAL UNITED HOSPITALS
BATH NHS FOUNDATION TRUST)
Sent: 08 April 2016 12:15
To: [log in to unmask]
Subject: Elevated Trop T necrotic
pancreatis
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Dear
Mailbase,
Can anyone help with
the following?
ITU patient admitted
with acute pancreatitis 16/3/16 due to ?alcohol/drugs,
developed rhabdomyolysis with a peak CK (25/3/16) of 127k,
haemofiltered, latest
CK (5/4/16) is normal.
Troponin T (hs Cobas
method) first measured 30/3/16 = 1317 ng/L, further
increased over next few days to peak at 5225 ng/L on 6/4/16,
latest result is 5098
ng/L on 7/4/16.
No abnormality of
heart detected by scans etc.
The reason for the
troponin request in the first place was non-specific –
just what ITU tend to do in septic patients!
He has a necrotic
head of pancreas.
Question:
Could the necrotic
pancreas be releasing troponin or something that’s
cross-reacting or causing interference in the Troponin T
assay?
I would be grateful
of any suggestions as the what could be going on
here.
Many
thanks,
Nicola
Nicola
Pullan
Principal Clinical Biochemist
Royal United
Hospitals Bath NHS Foundation Trust
Combe Park, Bath, BA1 3NG
Dir Line: 01225
824711
Visit our website at: www.ruh.nhs.uk/pathology
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