Serum aldolase with creatine kinase in current clinical practice

Area of Science:

• Clinical Biochemistry
• Diagnostic Biomarkers
• Neuromuscular Disorders

Background:

• Serum aldolase (ALD) and creatine kinase (CK) are enzymes evaluated in the diagnosis of muscle diseases.
• Establishing clear clinical laboratory policies for enzyme testing is crucial for accurate diagnosis and patient management.
• The diagnostic utility of ALD, especially in relation to CK, requires further clarification for routine clinical use.

Purpose of the Study:

• To develop a clinical laboratory policy for serum aldolase (ALD) testing requests.
• To evaluate the combined diagnostic utility of serum aldolase (ALD) and serum creatine kinase (CK) in patients.
• To determine the specific role of ALD in diagnosing and monitoring muscle diseases, particularly when CK levels are normal.

Main Methods:

• A study involving 126 consecutive patients with suspected muscle disease.
• Measurement of serum aldolase (ALD) and serum creatine kinase (CK) levels.
• Analysis of enzyme levels in conjunction with clinical data to assess diagnostic patterns.

Main Results:

• In 60.3% of patients, both ALD and CK levels were normal.
• Elevated ALD with normal CK was observed in 15.1% of cases, suggesting potential utility in specific diagnostic scenarios.
• The spectrum of muscle diseases observed was similar regardless of which enzyme was elevated, but ALD showed diagnostic value when CK was within the reference range.

Conclusions:

• Serum aldolase (ALD) plays a significant role in the diagnosis and monitoring of muscle disease, especially when serum creatine kinase (CK) levels are within the normal reference range.
• The findings support the development of specific clinical laboratory guidelines for ordering and interpreting ALD tests in conjunction with CK.
• ALD testing can provide valuable diagnostic information in cases where CK alone may not be sufficiently indicative of muscle pathology.