Deutsche medizinische Wochenschrift (1946) · 2010
[Typical laboratory constellation of a non-ST-segment elevation myocardial infarction in polymyositis].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Bittenbring J T, Chen C-H, Fries P, Böhm M, Kilter H
Аннотация
HISTORY AND ADMISSION FINDINGS: a 80-year-old women was admitted with a hypertensive crisis. Laboratory tests showed elevated cardiac enzymes (CK, CK-MB and troponin T). She was treated for suspected non-ST segment elevation myocardial infarction.
INVESTIGATIONS: a cardiovascular examination, which included echocardiography, coronary angiography and magnetic resonance imaging, excluded a cardiac cause of the laboratory reults. After complete assessment the patient was found to have long-standing polymyosits positive for Mi-2 antibodies. This had caused troponin T elevation from the release of regenerating muscles after chronic inflammatory damage. Troponin I, however, is truly cardiomyocyte specific and distinguishes between cardiac and non cardiac origin of CK, CK-MB and troponin T.
TREATMENT AND COURSE: prednisone medication was started with a single dose of 50mg, then gradually reduced. Follow-up examination merely revealed minimally active polymyositis.
CONCLUSION: troponin I should be measured in patients with inflammatory myositis/myopathies in order to diagnose and assess cardiac involvement.
INVESTIGATIONS: a cardiovascular examination, which included echocardiography, coronary angiography and magnetic resonance imaging, excluded a cardiac cause of the laboratory reults. After complete assessment the patient was found to have long-standing polymyosits positive for Mi-2 antibodies. This had caused troponin T elevation from the release of regenerating muscles after chronic inflammatory damage. Troponin I, however, is truly cardiomyocyte specific and distinguishes between cardiac and non cardiac origin of CK, CK-MB and troponin T.
TREATMENT AND COURSE: prednisone medication was started with a single dose of 50mg, then gradually reduced. Follow-up examination merely revealed minimally active polymyositis.
CONCLUSION: troponin I should be measured in patients with inflammatory myositis/myopathies in order to diagnose and assess cardiac involvement.