Stručni rad

https://doi.org/10.11613/BM.2019.021001

Description of interference in the measurement of troponin T by a high-sensitivity method

Miguel Aliste-Fernández orcid.org/0000-0002-2558-6103 ; Clinical Laboratory, Biochemistry Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
Gemma Sole-Enrech ; Clinical Laboratory, Biochemistry Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
Ruth Cano-Corres ; Clinical Laboratory, Biochemistry Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
Silvia Teodoro-Marin ; Pediatric Medicine, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
Eugenio Berlanga-Escalera ; Clinical Laboratory, Biochemistry Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain

Sažetak

Introduction: Measurement of high-sensitivity troponin T (hs-TnT) has become an essential step in the diagnosis of acute myocardial infarction.
This high-sensitivity method allows quantifying the concentration of troponin T in blood of healthy subjects with a lower inaccuracy compared to
previous reagent generations. However, the presence of certain compounds in the sample may interfere with the result. We present a patient who
had repeatedly high concentrations of hs-TnT in the serum sample that did not agreed with the signs and symptoms. In addition, ultrasensitive troponin
I concentration was undetectable.
Materials and methods: To investigate the presence of an interfering compound, different analysis were carried out. In order to discard macro
complexes in the sample, the serum was precipitated with polyethylene glycol. In addition, the serum was incubated with Scantibodies Heterophilic
Blocking Tube, which can block heterophilic antibodies. Finally, a size exclusion chromatography of the sample was performed by the manufacturer.
What happened: The interfering substance was allocated into fractions with proteins of 150kDa, corresponding to high molecular weight proteins
like immunoglobulin G (IgG). This compound was responsible for the falsely elevated hs-TnT results and it affected only the high-sensitivity methods.
Main lesson: The detected interfering compound was probably an IgG. This type of interference must be kept in mind in front of discordant results,
even if they are extremely rare. Therefore, interdisciplinary cooperation between clinicians, laboratory and manufacturer is essential.

Ključne riječi

high-sensitivity troponin T; interference; case report

Hrčak ID:

221086

URI

https://hrcak.srce.hr/221086

Datum izdavanja:

15.6.2019.

Posjeta: 944 *