Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain
Patients with systemic lupus erythematosus (SLE) presenting with chest pain pose a unique diagnostic challenge, with causes ranging from cardiopulmonary disease to esophageal disorders and musculoskeletal chest wall pain. The most common biomarkers for myocardial injury are cardiac troponin T and I...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2020/8884759 |
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| author | Guy Katz Sharon L. Kolasinski Baskaran Sundaram Giorgos Loizidis |
| author_facet | Guy Katz Sharon L. Kolasinski Baskaran Sundaram Giorgos Loizidis |
| author_sort | Guy Katz |
| collection | DOAJ |
| description | Patients with systemic lupus erythematosus (SLE) presenting with chest pain pose a unique diagnostic challenge, with causes ranging from cardiopulmonary disease to esophageal disorders and musculoskeletal chest wall pain. The most common biomarkers for myocardial injury are cardiac troponin T and I (cTnT and cTnI) due to their high sensitivity for the early detection of myocardial infarction. In the idiopathic inflammatory myopathies, cTnT is commonly elevated, and this reflects skeletal muscle breakdown rather than myocardial damage. Similar observations have not been reported in SLE myositis to date. We present two cases of patients with SLE and associated myositis who presented with chest pain and elevated cTnT. Both patients had a normal cTnI, transthoracic echocardiogram, and cardiac magnetic resonance imaging, likely indicating noncardiac chest pain. Clinicians should be aware that the specificity of cTnT might be lower in SLE myositis and that cTnI elevation may be more specific in detecting myocardial insult. |
| format | Article |
| id | doaj-art-721d478e873e410db5fed8700565ba3e |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-721d478e873e410db5fed8700565ba3e2025-02-03T01:05:15ZengWileyCase Reports in Rheumatology2090-68892090-68972020-01-01202010.1155/2020/88847598884759Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest PainGuy Katz0Sharon L. Kolasinski1Baskaran Sundaram2Giorgos Loizidis3Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Bulfinch 165, 55 Fruit St., Boston, MA 02114, USADivision of Rheumatology, University of Pennsylvania Perelman School of Medicine, Penn Musculoskeletal Center, 3737 Market Street, 8th Floor, Philadelphia, PA 19104, USADepartment of Radiology, Division of Cardiothoracic Radiology, Thomas Jefferson University, 132 South 10th Street, 10th Floor, The Main Building, Philadelphia, PA 19107, USADivision of Rheumatology, Department of Medicine, Thomas Jefferson University, 211 South 9th Street, Suite 600, Philadelphia, PA 19107, USAPatients with systemic lupus erythematosus (SLE) presenting with chest pain pose a unique diagnostic challenge, with causes ranging from cardiopulmonary disease to esophageal disorders and musculoskeletal chest wall pain. The most common biomarkers for myocardial injury are cardiac troponin T and I (cTnT and cTnI) due to their high sensitivity for the early detection of myocardial infarction. In the idiopathic inflammatory myopathies, cTnT is commonly elevated, and this reflects skeletal muscle breakdown rather than myocardial damage. Similar observations have not been reported in SLE myositis to date. We present two cases of patients with SLE and associated myositis who presented with chest pain and elevated cTnT. Both patients had a normal cTnI, transthoracic echocardiogram, and cardiac magnetic resonance imaging, likely indicating noncardiac chest pain. Clinicians should be aware that the specificity of cTnT might be lower in SLE myositis and that cTnI elevation may be more specific in detecting myocardial insult.http://dx.doi.org/10.1155/2020/8884759 |
| spellingShingle | Guy Katz Sharon L. Kolasinski Baskaran Sundaram Giorgos Loizidis Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain Case Reports in Rheumatology |
| title | Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain |
| title_full | Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain |
| title_fullStr | Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain |
| title_full_unstemmed | Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain |
| title_short | Elevated Cardiac Troponin T in Patients with Lupus Myositis Presenting with Noncardiac Chest Pain |
| title_sort | elevated cardiac troponin t in patients with lupus myositis presenting with noncardiac chest pain |
| url | http://dx.doi.org/10.1155/2020/8884759 |
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