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ghlester wrote: > > We have been working up Abbott AxSYM Troponin I assay for introduction into > routine service. Presently we do Vitros total CK with AxSYM CK-MB mass in > selected cases by special request. We have been doing TnI on these CK-MBs > in parallel. Findings reinforce the paper in Feb 99 Clinical Chemistry but > we came across this case which has puzzeled us. Does anyone have any > experience to throw light on the situation? > > A 93 year old lady admitted via A&E (ER for colleagues in US) with history > of "fall, collapsed, low temperatue ?cause". > > Admission: CK 1372 iu/L (Ref Range < 135) > CK-MB 131 ug/L ( < 7.0 ) > TnI 0.2 ug/L > > 9 hours later: CK 794 > CK-MB 68.4 > TnI 0.2 > Trop T 0.02 ug/L ( < 0.10 ) > Non-specific ECG changes were noted. > > 35 hours later: CK 428 > CK-MB 22.9 > TnI 0.1 > > Do the AxSYM CK-MB or TnI assay suffer HMMA effects? Results of CK > isoenzymes by electrophoresis are awaited. > > Thanks > > Geoff Lester > Chemical Pathology Department > Frenchay Hospital > BRISTOL UK. > [log in to unmask] Geoff, Do you have any information about thyroid status. I'm not sure it would be the full explanation but hypothyroidism could give raised CKMB fraction in the absence of cardiac problems and this would also be consistent with the clinical presentation. Treatment might also explain the subsequent changes. In our biochemistry lab we often would not receive any information on the thyroid status when cardiac tests were being requested. I agree with those who doubt a tumour cause. -- Dr Peadar McGing, Principal Biochemist, Biochemistry Dept, Mater Hospital, Dublin 7, Ireland. Tel: (+353 1)8032080; Fax: (+353 1)8034781. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%