Discordant Cardiac Troponin Results in Amphetamine - Related Rhabdomyolysis

Abstract

A case of a patient who developed amphetamine-related rhabdomyolysis and acute renal failure after an intestinal operation is reported. He initially had biochemical evidence of myocardial injury, with a concomitant increase in cardiac marker proteins CK-MB, cardiac troponin T (cTnT) and cardiac troponin I (cTnI) during the acute event. Following intensive treatment and improvement in renal function, levels of all myocardial marker proteins fell towards the normal range. Late in the course of the disease, however, there were re-elevations of CK-MB and cTnT, but not of cTnI, to levels exceeding 14 fold and 8 fold the upper limit of the reference range, respectively. Since, at present the possibility of re-expression of both CK-MB and cTnT in damaged and regenerating skeletal muscle can not be ruled out, the late occurrence of increased CK-MB and cTnT in our patient should not be interpreted as evidence of recurrent myocardial injury.