Macrotroponin as a cause of falsely elevated cardiac troponin in systemic sclerosis

This case report discusses a patient in his late 30s with recent diagnosis of systemic sclerosis who presented with persistently elevated cardiac troponin (cTn) levels, raising concerns for cardiac involvement. Despite elevated troponin-I and troponin-T, clinical investigations, including echocardiogram and cardiac MRI, were unremarkable. The persistence of elevated troponin without corresponding clinical evidence prompted further investigation, leading to the identification of macrotroponin as the cause. This case emphasises the importance of recognising macrotroponin as an interferent in patients with unexplained raised troponin levels to avoid unnecessary cardiac interventions.