HETEROPHILE ANTIBODIES – A RARE BUT SIGNIFICANT CAUSE OF FALSE POSITIVE CARDIAC TROPONIN LEVELS

Highlights

Practitioners regularly encounter unexplained (false-positive) causes and mechanisms of increased concentrations of cardiac troponins. One of the most significant and common causes of false increases in cardiac troponin levels are heterophile antibodies. There are no articles in domestic and foreign databases that systematize in detail information about the prevalence, mechanisms of increase and ways to combat this cause of false-positive increase in cardiac troponin concentration, which was the purpose of this manuscript.

Annotation

According to traditional concepts, cardiospecific troponins (cTnT and cTnI) are the most important laboratory biomarkers with high diagnostic value in myocardial infarction (MI). The development of new generations of methods for determining cTnT and cTnI, also called high- and ultra-sensitive methods, has expanded the diagnostic capabilities of cardiac troponins in relation to other diseases in which myocardial tissue is involved in the pathological process, thereby carrying additional prognostic value. Given the wide scope for use of cTnT and cTnI, which is not limited to the diagnosis of MI, there is an urgent need to carefully identify all factors that can in any significant way affect or distort the result of laboratory testing of blood serum for cTnT and cTnI. Among all known factors affecting the concentration of cTnT and cTnI, heterophile antibodies are the most significant in terms of the degree of change (increase) in serum levels. In this review, we will consider the main causes of the formation of heterophile antibodies, the mechanisms of their influence on the concentration of cTnT and cTnI, as well as methods for detecting and combating heterophile antibodies.

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