Circulating Heterophile Antibodies Causing Cardiac Troponin Elevation: An Unusual Differential Diagnosis of Myocardial Disease

Luís Graça Santos; Rita Ribeiro Carvalho; Fernando Montenegro Sá; Francisco Soares; Sidarth Pernencar; Ricardo Castro; João Morais

doi:10.1016/j.jaccas.2020.01.011

Circulating Heterophile Antibodies Causing Cardiac Troponin Elevation: An Unusual Differential Diagnosis of Myocardial Disease

JACC Case Rep. 2020 Mar 18;2(3):456-460. doi: 10.1016/j.jaccas.2020.01.011. eCollection 2020 Mar.

Authors

Luís Graça Santos¹, Rita Ribeiro Carvalho¹, Fernando Montenegro Sá¹, Francisco Soares¹, Sidarth Pernencar¹, Ricardo Castro², João Morais¹

Affiliations

¹ Department of Cardiology, Leiria Hospital Centre, Leiria, Portugal.
² Department of Clinical Pathology, Leiria Hospital Centre, Leiria, Portugal.

Abstract

We present the case of a female patient who developed persistently elevated levels of cardiac troponin (cTn) after a previous episode of clinically presumed myocarditis. Extensive investigation concluded that the presence of heterophile antibodies was causing false positive cTn elevation. (Level of Difficulty: Intermediate.).

Keywords: CAD, coronary artery disease; CK, creatine kinase; CMR, cardiac magnetic resonance; CRP, C-reactive protein; ECG, electrocardiogram; MINOCA, myocardial infarction with nonobstructive coronary arteries; RL, reference limit; cTn, cardiac troponin; cardiac magnetic resonance; echocardiography; hAb, heterophile antibody; myocardial infarction; speckle tracking.

Publication types

Case Reports