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[Activity of creatine kinase and its isoenzymes in hemolytic uremic syndrome]
Insights
Children with hemolytic uremic syndrome (HUS) show elevated serum creatine kinase (CK) levels, particularly CK-MM, CK-MB, and CK-BB isoenzymes, indicating muscle damage. These enzyme elevations correlate with disease severity, suggesting potential roles for anoxia and toxins.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical Chemistry
Context:
- Hemolytic uremic syndrome (HUS) is a serious condition affecting children.
- Serum creatine kinase (CK) and its isoenzymes are markers of muscle damage.
- Understanding enzyme kinetics in HUS is crucial for diagnosis and prognosis.
Purpose:
- To investigate serum creatine kinase (CK) and CK isoenzyme levels in children with HUS.
- To correlate CK levels with disease progression and clinical parameters.
- To explore potential etiological factors for enzyme release in HUS.
Summary:
- Serum total CK and CK isoenzymes (CK-MM, CK-MB, CK-BB) were measured in HUS patients and healthy controls.
- Elevated total CK activity, primarily due to increased CK isoenzymes, was observed in HUS patients, persisting for up to a week.
- A subgroup of HUS patients (G2) exhibited significantly higher CK levels, correlated with decreased platelet counts and increased urea and fibrinogen degradation products.
Impact:
- This study highlights elevated serum CK as a potential biomarker in pediatric HUS.
- Findings suggest muscle injury may be a component of HUS pathophysiology.
- Further research into the mechanisms of enzyme release, possibly involving anoxia or toxins, is warranted.
Abstract:
Serum creatine kinase (CK) and CK isoenzymes (CK-MM, CK-MB and CK-BB) were measured in 35 healthy and 25 children with hemolytic uremic syndrome (HUS) at 48 h, 7 and 15 days after admittance. Total serum CK activity was measured with a commercially available kit ("CK-NAC", by Merck, cat 14327) and CK isoenzymes using the Helena laboratories method. The interassay coefficients of variation with these methods are the following: for the total CK activity, 10.95 and 9.15% for an enzyme activity of 42 and 142 U/L respectively; for the activity of the isoenzymes, 6.8, 8.0 and 15.1% for activities of 102, 67 and 30 U/L. Total CK activity at 48 h in HUS patients defined two groups, group 1 (G1) which is not different from the control group (CG) and group 2 (G2) which had a significantly higher activity, p less than 0.0005. The increase in total CK remained significant until the first week. Increase in total CK resulted from the increase in CK isoenzymes: CK-MM, CK-MB and CK-BB. Highly significant correlation coefficients (p less than 0.0005) were obtained between total CK and their isoenzymes. When we examined both groups of patients in relation to clinical parameters, no difference could be found although G2 showed higher urea and fibrinogen degradation products with significantly decreased platelet counts. Although the reasons for enzyme release are not understood, anoxia and chemical toxins have been incriminates.(ABSTRACT TRUNCATED AT 250 WORDS)