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Asymptomatic hyper-CK-emia: an electrophysiologic and histopathologic study
Muscle & Nerve
|March 1, 1989
Summary
Persistent elevation in creatine kinase (CK) levels, even without symptoms, often indicates underlying mild or early myopathy. Further investigation with electromyography and muscle biopsy can reveal various muscle disorders.
Area of Science:
- Neurology
- Clinical Diagnostics
- Muscle Diseases
Background:
- Routine creatine kinase (CK) measurement has increased the identification of patients with unexplained CK elevation.
- Asymptomatic hyper-CK-emia presents a diagnostic challenge in clinical practice.
Purpose of the Study:
- To investigate the underlying causes of persistent, unexplained creatine kinase elevation in asymptomatic individuals.
- To determine the diagnostic yield of electromyography (EMG) and muscle biopsy in these patients.
Main Methods:
- Study included 19 patients with persistent CK elevation of unknown etiology.
- Diagnostic tools employed were needle electromyography (EMG) and muscle biopsy.
- Patients were followed for the development of weakness.
Main Results:
- Electromyography (EMG) was abnormal in 14 out of 19 patients.
- Muscle biopsy confirmed a myopathic diagnosis in all patients with abnormal EMG and one with normal EMG.
- Diagnoses included polymyositis, nonspecific myopathy, mitochondrial myopathy, and various other myopathies.
- Five patients with abnormal biopsies developed clinical weakness within one year.
Conclusions:
- Persistent asymptomatic hyper-CK-emia frequently indicates an underlying, often mild or early-stage, myopathy.
- Electromyography and muscle biopsy are valuable diagnostic tools for identifying muscle disorders in these patients.
- Early detection may allow for timely management and monitoring of potential disease progression.