{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T10:36:32Z","timestamp":1756636592675},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,11,15]],"date-time":"2021-11-15T00:00:00Z","timestamp":1636934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>A patient presented to hospital with chest pain and shortness of breath on 2 occasions 4 weeks apart. Clinical examination revealed an elevated jugular venous pressure consistent with heart failure or elevated filling pressures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The patient was investigated through various modalities including electrocardiogram (ECG), transthoracic echocardiogram, coronary angiography, MRI, cardiac catheterization, positron emission tomography, and an extensive laboratory workup.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Serial hs TnI measurements consistently revealed grossly elevated troponin I (&amp;gt;10 000\u2009ng\/L). In-lab investigation of increased high sensitivity troponin I (hsTnI) showed evidence of falsely increased troponin due to the presence of heterophilic antibodies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case demonstrates a complex patient presentation and the value of involving the laboratory medicine team when dealing with potentially discrepant results. This is a rare report of grossly elevated troponin due to heterophilic antibodies for high-sensitivity troponin Abbott assay.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfab119","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T11:11:17Z","timestamp":1631790677000},"page":"575-581","source":"Crossref","is-referenced-by-count":1,"title":["A Diagnostic Dilemma from a Presentation of Shortness of Breath and Chest Pain"],"prefix":"10.1093","volume":"7","author":[{"given":"Matthew","family":"Nichols","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Candice K","family":"Silversides","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Woo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Pathology and Lab Medicine, Mount Sinai Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Taher","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada"},{"name":"Department of Pathology and Lab Medicine, Mount Sinai Hospital, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianghua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Division of Clinical Biochemistry, University Health Network, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davor","family":"Brinc","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada"},{"name":"Division of Clinical Biochemistry, University Health Network, Toronto, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,15]]},"reference":[{"key":"2022030208031768200_jfab119-B1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1258\/000456306777695744","article-title":"On the interpretation of affirmative follow-up tests in immunoassays: what must not be done?","volume":"43","author":"Ismail","year":"2006","journal-title":"Ann Clin 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