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April 22/29, 1998

False-Negative Qualitative Troponin T—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(16):1262-1263. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-16-jac80007

In Reply.—Dr Belmin and colleagues suggest the possibility that a macroenzyme might have been erroneously detected in our patient and misinterpreted as an increase in CK-MB. Macroenzymes are potential confounders of laboratory tests, often producing isolated and sustained findings.1 Macro CKs have been typically observed using methods in which the 3 isoenzymes are resolved from one another based on differences in relative molecular size, as in gel electrophoresis. Apparent molecular size of the isoenzyme is increased due to the association with molecules, such as antibodies in the blood.2