1. [Typical laboratory constellation of a non-ST-segment elevation myocardial infarction in polymyositis].
- Author
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Bittenbring JT, Chen CH, Fries P, Böhm M, and Kilter H
- Subjects
- Aged, 80 and over, Anti-Inflammatory Agents therapeutic use, Coronary Angiography, Creatine Kinase, MB Form blood, Diagnosis, Differential, Female, Humans, Magnetic Resonance Angiography, Myocardial Infarction blood, Polymyositis blood, Polymyositis drug therapy, Prednisone therapeutic use, Creatine Kinase blood, Myocardial Infarction diagnosis, Polymyositis diagnosis, Troponin T blood
- Abstract
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.
- Published
- 2010
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