St.Emlyn's - By Rick Body - August 8, 2018
"What does it mean for clinicians in the ED?
There are three things that every emergency physician needs to know:
- First, you need to know what troponin assay you’re using and whether biotin may interfere with the assay. Check the IFCC table I linked to above to be sure.
- Second, if your assay is subject to interference, then remember to ask every patient about biotin intake. They may not know that they’re taking biotin – so ask about any supplements, and get the details if they are taking supplements.
- Third, if your patient is taking biotin supplements (especially at high dose) then don’t automatically trust a negative troponin result. Check with your biochemistry lab. They may recommend sending the sample out to another lab to check with another assay, or if you’re really lucky they may be able to measure biotin levels (don’t expect that to be quick though!). As getting a definitive answer may take some time, it’s important to exercise your clinical judgement. It the clinical situation means that you would have expected a high troponin result, be sure not to trust a negative result if your patient is on high dose biotin."