Myocarditis laboratory findings: Difference between revisions

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{{Myocarditis}}
{{Myocarditis}}
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Varun Kumar|Varun Kumar, M.B.B.S.]]
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Varun Kumar|Varun Kumar, M.B.B.S.]]
==Overview==


==Inflammatory Markers==
==Inflammatory Markers==
Line 13: Line 11:
==Markers of Myonecrosis==
==Markers of Myonecrosis==
The following markers of myonecrosis is often elevated in myocarditis:
The following markers of myonecrosis is often elevated in myocarditis:
*[[Creatine Kinase]]:
*[[Creatine Kinase]] (CK-MB)
*Cardiac [[troponin]] I (cTnI)
*Cardiac [[troponin]] I (cTnI) or T (cTnT) are elevated more frequently than CK-MB (34-53% versus 2-6 %) as reported in two series<ref name="pmid8994432">{{cite journal| author=Smith SC, Ladenson JH, Mason JW, Jaffe AS| title=Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. | journal=Circulation | year= 1997 | volume= 95 | issue= 1 | pages= 163-8 | pmid=8994432 | doi= | pmc= | url= }} </ref><ref name="pmid9350939">{{cite journal| author=Lauer B, Niederau C, Kühl U, Schannwell M, Pauschinger M, Strauer BE et al.| title=Cardiac troponin T in patients with clinically suspected myocarditis. | journal=J Am Coll Cardiol | year= 1997 | volume= 30 | issue= 5 | pages= 1354-9 | pmid=9350939 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9350939  }} </ref>. cTnI is elevated early in the course and is suggestive of acute myocarditis<ref name="pmid8994432">{{cite journal| author=Smith SC, Ladenson JH, Mason JW, Jaffe AS| title=Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates. | journal=Circulation | year= 1997 | volume= 95 | issue= 1 | pages= 163-8 | pmid=8994432 | doi= | pmc= | url= }} </ref>. Persistently elevated cTnT or CK-MB is suggestive of ongoing necrosis. Cardiac enzymes may also be useful in differentiating myocarditis from dilated cardiomyopathy as demonstrated in a series in Thailand<ref name="pmid12211203">{{cite journal| author=Soongswang J, Durongpisitkul K, Ratanarapee S, Leowattana W, Nana A, Laohaprasitiporn D et al.| title=Cardiac troponin T: its role in the diagnosis of clinically suspected acute myocarditis and chronic dilated cardiomyopathy in children. | journal=Pediatr Cardiol | year= 2002 | volume= 23 | issue= 5 | pages= 531-5 | pmid=12211203 | doi= | pmc= | url= }} </ref>. CK-MB and cTnT levels were found to be higher in myocarditis than dilated cardiomyopathy.
* [[LDH]]: depends on the extent of myocardial involvement
* Serum [[myoglobin]]


==References==
==References==

Revision as of 18:57, 25 August 2011

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Inflammatory Markers

The following inflammatory markers are often elevated:

Markers of Myonecrosis

The following markers of myonecrosis is often elevated in myocarditis:

  • Creatine Kinase (CK-MB)
  • Cardiac troponin I (cTnI) or T (cTnT) are elevated more frequently than CK-MB (34-53% versus 2-6 %) as reported in two series[1][2]. cTnI is elevated early in the course and is suggestive of acute myocarditis[1]. Persistently elevated cTnT or CK-MB is suggestive of ongoing necrosis. Cardiac enzymes may also be useful in differentiating myocarditis from dilated cardiomyopathy as demonstrated in a series in Thailand[3]. CK-MB and cTnT levels were found to be higher in myocarditis than dilated cardiomyopathy.

References

  1. 1.0 1.1 Smith SC, Ladenson JH, Mason JW, Jaffe AS (1997). "Elevations of cardiac troponin I associated with myocarditis. Experimental and clinical correlates". Circulation. 95 (1): 163–8. PMID 8994432.
  2. Lauer B, Niederau C, Kühl U, Schannwell M, Pauschinger M, Strauer BE; et al. (1997). "Cardiac troponin T in patients with clinically suspected myocarditis". J Am Coll Cardiol. 30 (5): 1354–9. PMID 9350939.
  3. Soongswang J, Durongpisitkul K, Ratanarapee S, Leowattana W, Nana A, Laohaprasitiporn D; et al. (2002). "Cardiac troponin T: its role in the diagnosis of clinically suspected acute myocarditis and chronic dilated cardiomyopathy in children". Pediatr Cardiol. 23 (5): 531–5. PMID 12211203.

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