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Dear Colleagues, I would welcome comments, thoughts or suggestions in the following case (I have abbreviated the details to keep the length of the posting down). A 70y old male (past history of MI and CABG) with paroxysmal AF but no chest pain had an elevated TnT -0.17 ug/L. TnI (Axsym) in the local A/E was < 0.3 ug/L. ECG showed AF with no ischaemia. TnI checked on Bayer Centaur was < 0.1 ug/L. TnT has been elevated to the same degree and TnI undetectable on 3 further occasions (including after his AF was controlled). There appears to be no clear evidence of heterophile antibody interference in either the TnT or Bayer TnI assays (using Scantibody tubes, incubation with goat serum and immunofixation against goat serum). CKMB was assayed in two samples and was elevated at 41.7 and 31.0 ug/L (normal <5). Other tests: renal function normal, slight neutropaenia with borderline low platelet count - otherwise nil of note. We were initially chasing "false negative" troponin Is but now wonder if there may be another explanation for the expression of TnT and CKMB but not TnI. Any ideas anyone? Best wishes Geoff Smith _________________________________________ Geoff Smith Chemical Pathologist Southern Community Laboratories Ltd 444 Durham Street Christchurch PO Box 21 049 New Zealand email: [log in to unmask] Telephone: +64 3 366 2368 Fax: +64 3 366 2632 __________________________________________ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/