Macro-CK in 82 year old woman. A case report

We report the case of an 82-year old female patient admitted to the emergency department after fainting episode, low blood pressure, and arrhythmia. The patient reported a watery diarrhea of 3 weeks duration. Extremely high total creatinine kinase (CK) and CK-MB activity but normal troponin level were measured. Laboratory investigation showed the presence of macro form of CK. Abnormal CK and CK-MB activity was still measured eight months after patient episode. Due to unexplained watery diarrhea during three weeks before admission several tests for presence of autoantibodies were performed. The only positive result has been noted for anti-Saccharomyces cerevisiae antibodies (ASCA), IgG isotype.