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Related Experiment Videos

[Differential diagnostic considerations in CK-MB level increase].

W J Z'Graggen1, C Wehrli, K Gautschi

  • 1Departement Innere Medizin, Kantonsspital Aarau.

Praxis
|December 8, 2000
PubMed
Summary
This summary is machine-generated.

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Elevated creatine kinase MB fraction levels in two patients hospitalized for thrombo-embolic disease were caused by macro creatine kinase type I and elevated creatine kinase BB fraction, not heart damage.

Area of Science:

  • Biochemistry
  • Clinical Chemistry
  • Cardiology

Background:

  • Thrombo-embolic disease necessitates hospitalization and careful diagnostic evaluation.
  • Elevated creatine kinase (CK) activity, particularly the MB fraction, is a marker often associated with myocardial infarction.

Observation:

  • Two patients hospitalized for thrombo-embolic disease presented with elevated total CK activity.
  • In both patients, the creatine kinase MB fraction value exceeded the total CK activity, a highly unusual finding.

Findings:

  • Immunoinhibition assays revealed the elevated CK MB fraction was due to non-standard CK forms.
  • One patient exhibited macro creatine kinase type I, associated with ulcerative colitis.
  • The other patient showed a highly elevated creatine kinase BB fraction, linked to prostatic carcinoma.

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Implications:

  • This case series highlights the importance of investigating atypical causes of elevated CK MB fraction.
  • Macro creatine kinase type I and elevated CK BB fraction can mimic cardiac injury markers in thrombo-embolic disease patients.
  • Accurate CK isoenzyme analysis is crucial for correct diagnosis and patient management, avoiding misdiagnosis of myocardial infarction.