Macrotroponin as a cause of falsely elevated cardiac troponin in systemic sclerosis
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Accepted Version
Date
2025-09-17
Authors
Tio, Sherdya
Zia, Fatima
Joyce, Caroline Martha
Halsall, David J.
Ryan, John
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Publishing Group
Published Version
Abstract
This case report discusses a patient in his late 30s with recent diagnosis of systemic sclerosis (SSc) who presented with persistently elevated cardiac troponin (cTn) levels, raising concerns for cardiac involvement. Despite elevated troponin-I (cTnI) and troponin-T (cTnT), clinical investigations, including echocardiogram and cardiac MRI, were unremarkable. The persistence of elevated troponin without corresponding clinical evidence prompted further investigation, leading to the identification of macrotroponin as the cause. This case emphasizes the importance of recognising macrotroponin as an interferent in patients with unexplained raised troponin levels to avoid unnecessary cardiac interventions.
Acknowledgements for their contribution in patient care and clinical insights relevant to the case:
Professor Gráinne Murphy and Professor Sinead Harney, Consultant Rheumatologist, Cork University Hospital
Dr Ronan Curtin, Consultant Cardiologist, Cork University Hospital
Description
Keywords
Systemic sclerosis , SSc , Elevated cardiac troponin , cTn
Citation
Tio, S., Zia, F., Joyce, C.M., Halsall, D.J. and Ryan, J. (2025) 'Macrotroponin as a cause of falsely elevated cardiac troponin in systemic sclerosis', BMJ Case Reports, 18(9), e266536 (7pp). https://doi.org/10.1136/bcr-2025-266536