{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:40:20Z","timestamp":1756374020695,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,6,5]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:p>Troponins are an excellent sensitive marker for myocardial ischaemic damage. However, there are several non-ischaemic cardiac and non-cardiac reasons for troponin elevation. Many cases of troponin T elevation and some troponin I cases have been reported in the literature due to inflammatory muscle disease. Here, we report a woman in her 50s who initially presents with fatigue and weakness, and is found to have elevated troponin T. The patient was appropriately worked up for cardiac causes with ECG and echocardiogram. She had positive antinuclear antibodies, antineutrophil cytoplasmic antibody and myositis panel. The elevation of troponins was attributed to polymyositis and treated with methotrexate and prednisone with recovery of patient\u2019s symptoms. This article emphasises the struggle of diagnosis in a patient with no reported medical history, having low to moderate risk of silent myocardial infarction.<\/jats:p>","DOI":"10.1136\/bcr-2023-255312","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T10:15:15Z","timestamp":1687169715000},"page":"e255312","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["The rise and fall of troponin in a patient with polymyositis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1931-5497","authenticated-orcid":false,"given":"Faiza","family":"Javed","sequence":"first","affiliation":[{"name":"University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Leung","sequence":"additional","affiliation":[{"name":"University of Kentucky, Lexington, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"2025082802032199000_16.6.e255312.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.070"},{"key":"2025082802032199000_16.6.e255312.2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.59566\/IJBS.2013.9107","article-title":"Misleading elevation of troponin T caused by polymyositis","volume":"9","author":"Dhir","year":"2013","journal-title":"Int J Biomed Sci"},{"key":"2025082802032199000_16.6.e255312.3","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1007\/s10067-022-06401-x","article-title":"Cardiac involvement in anti-MDA5 dermatomyositis: a case-based review","volume":"42","author":"Quintero-Gonz\u00e1lez","year":"2023","journal-title":"Clin Rheumatol"},{"key":"2025082802032199000_16.6.e255312.4","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.090562"},{"key":"2025082802032199000_16.6.e255312.5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1038\/s41572-021-00321-x","article-title":"Idiopathic inflammatory myopathies","volume":"7","author":"Lundberg","year":"2021","journal-title":"Nat Rev Dis Primers"},{"key":"2025082802032199000_16.6.e255312.6","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1536\/ihj.17-204","article-title":"Diagnostic approach to cardiac involvement in idiopathic inflammatory myopathies","volume":"59","author":"Chen","year":"2018","journal-title":"Int Heart J"},{"key":"2025082802032199000_16.6.e255312.7","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2022.1056400","article-title":"Cardiac damage in autoimmune diseases: target organ involvement that cannot be ignored","volume":"13","author":"Pan","year":"2022","journal-title":"Front Immunol"},{"key":"2025082802032199000_16.6.e255312.8","doi-asserted-by":"crossref","first-page":"206","DOI":"10.2174\/1871528113666140526162640","article-title":"Cardiac and muscular involvement in idiopathic inflammatory myopathies: noninvasive diagnostic assessment and the role of cardiovascular and Skeletal magnetic resonance imaging","volume":"13","author":"Mavrogeni","year":"2014","journal-title":"Inflamm Allergy Drug Targets"},{"key":"2025082802032199000_16.6.e255312.9","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22026"},{"key":"2025082802032199000_16.6.e255312.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.08.013"},{"key":"2025082802032199000_16.6.e255312.11","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.21037\/apm-19-650","article-title":"The quest for diagnostic approaches of cardiac involvement in polymyositis and dermatomyositis","volume":"9","author":"Liu","year":"2020","journal-title":"Ann Palliat Med"},{"key":"2025082802032199000_16.6.e255312.12","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1111\/imj.15882","article-title":"Polymyositis and raised troponin after mRNA COVID-19 vaccination","volume":"52","author":"Ciofani","year":"2022","journal-title":"Intern Med J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:03:30Z","timestamp":1756371810000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,19]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bcr-2023-255312"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255312","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}