Assays for measuring the concentration of serum troponin are immune-based. Immunoassays are susceptible to interferences that can give misleading results.
Patient selection: elevated serum troponin concentration without evidence of cardiac disease
Possible interferences:
(1) patient antibodies to the animal that is the source for the monoclonal antibody used (HAMA, other)
(2) rheumatoid factor
(3) troponin specific autoantibody
(4) fibrin clots in the specimen
(5) macro-complex of troponin and immunoglobulin not due to other mechanisms
A macro-complex is suspected if the elevated troponin level disappears after treating the specimen with anti-human immunoglobulin antiserum, protein A or protein G.
If an immune interference is suspected, then an alternative test of myocardial injury may be necessary such as CK-MB.
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