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[Macromolecular creatinine kinase in patients diagnosed with ulcerative colitis]
J L Pérez Calle1, I M Marcos, J A Carneros
1Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid. jlperezc@medynet.com
Insights
Macromolecular creatinine kinase (macro-CK) type 1, an immunoglobulin-enzyme complex, can be detected in ulcerative colitis patients. Identifying macro-CK type 1 helps avoid misdiagnosis of heart disease in these individuals.
Area of Science:
- Clinical Biochemistry
- Immunology
- Gastroenterology
Background:
- Macromolecular creatinine kinase (macro-CK) type 1 is formed by immunoglobulin and creatinine kinase (CK) enzyme union.
- Macro-CK presence can lead to misdiagnosis of cardiac conditions, particularly ischemic heart disease.
- This macromolecule is observed in various diseases, with higher prevalence in autoimmune conditions.
Observation:
- Three ulcerative colitis cases exhibited elevated CK-MB isoenzyme levels exceeding total CK activity.
- Immunoinhibition assays quantified this discrepancy.
- Electrophoresis identified an atypical band, confirming macro-CK type 1.
Findings:
- The study identified macro-CK type 1 in patients with ulcerative colitis.
- This finding challenges typical diagnostic pathways for elevated cardiac enzymes.
- Ulcerative colitis is presented as a potential condition associated with macro-CK type 1.
Implications:
- Detecting macro-CK type 1 is crucial for accurate diagnosis in ulcerative colitis patients.
- It aids in preventing misdiagnosis of ischemic heart disease.
- This diagnostic marker can refine patient management and reduce unnecessary cardiac interventions.
Abstract:
Macromolecular creatinine kinase (macro-CK) type 1 is a macroenzyme formed by the union of an immunoglobulin with a creatinine kinase (CK) enzyme. Its presence in the blood may lead to misdiagnosis of heart disease. This macromolecule has been described in various diseases and is relatively more frequent those with autoimmune etiology. We describe three cases of ulcerative colitis that presented elevated MB-isoenzyme of CK activity greater than the total CK quantified by the immunoinhibition method. Electrophoresis revealed an atypical band that corresponded with the presence of a type 1 macroenzyme. Detection of this macromolecule could be useful in cases of ulcerative colitis when results of blood testing lead to suspicion of ischemic disease.