Interference by Human Anti-mouse Antibodies in Immunoassays: Falsely Elevated Cardiac Troponins Leading to Negative Coronary Angiograms
Journal Title: Annual Research & Review in Biology - Year 2015, Vol 6, Issue 5
Abstract
Cardiac Troponins are an extremely important indicator of myocardial injury and American College of Cardiology (ACC) and American Heart Association (AHA) guidelines include Cardiac Troponins as one of the major diagnostic criteria for myocardial damage. However in some instances the presence of heterophilic antibodies like Human Anti-Mouse Antibodies (HAMA) may interfere with the sandwich assays used for the detection and quantification of cardiac troponins giving false results which can have a major impact on the management of an individual suspected to have myocardial injury. We present a case of a 56 year old Caucasian male who had negative coronary angiogram 2 years ago presenting with acute chest pain and significantly elevated levels of Cardiac Troponin I (cTnI). He underwent cardiac catheterization which again turned out to be completely normal. His cTnI levels continued to be consistently elevated for months after cardiac catheterization. The reason for elevated cTnI levels was due to high levels of HAMA antibodies that caused heterophilic antibody interference in the assay of cTnI, resulting in falsely elevated levels of cTnI.
Authors and Affiliations
Mian Bilal Alam, Surachit Kumar, Ibrahim Sbietan, K. M. Anwar Hussain, Mehwish Asad, Asif N. Khan
‘Hemi-Section’: A Step-wise Conservative Approach
A 22 year old female patient had excruciating pain and a history of root canal treatment in relation to the left mandibular first molar. Upon clinical and radiographic evaluation; it was found having separated instrument...
Biotic Factors Affecting the Abundance of Vascular Epiphytic Bromeliads Growing in Cloud Forest in Reserva Biologica Los Cedros, Ecuador
Aims: In this paper we investigate whether the abundance of epiphytic bromeliads growing in cloud forest was affected by: (1) phorophyte family; (2) phorophyte size; and (3) the abundance of other epiphytes. Study Design...
CTLA4 Expression in Childhood Asthma and the Effect of Treatment with Inhaled Corticosteroid and Leukotriene Receptor Antagonist
Aims: Cytotoxic T lymphocyte antigen 4 (CTLA4), an important regulatory molecule in the process of antigen presentation, was previously associated with the pathogenesis of autoimmune diseases and asthma. Therefore, the g...
Antimicrobial Drug Resistance in Escherichia coli Including an O157:H7 Isolate from Feces of Healthy Goats in Grenada
Aim: To determine: the occurrence of Escherichia coli including the O157:H7 serotype in feces of healthy goats in 10 randomly selected farms in Grenada and the antimicrobial drug resistance in E. coli isolated from fece...
Effects of Boron Applications on the Physiology and Yield of Lettuce
Aim: The present study was conducted to determine the effects of boron applications on vegetative development, antioxidant activity and mineral composition of lettuce. Study Design: In the greenhouse, treatments arrange...