Asymptomatic hyperCKemia during a two-year monitoring period: A case report and literature overview

Area of Science:

• Biochemistry
• Clinical Medicine
• Neurology

Background:

• Elevated creatine kinase (CK) levels are indicative of various health conditions, including muscle damage, cardiac events, and metabolic disorders.
• Idiopathic hyperCKemia poses a diagnostic challenge for clinicians due to the lack of identifiable underlying causes.
• Despite diagnostic uncertainty, idiopathic hyperCKemia typically follows a benign long-term course.

Purpose of the Study:

• To report a case of idiopathic hyperCKemia in an asymptomatic patient.
• To illustrate the diagnostic process and long-term follow-up of a patient with significantly elevated serum CK levels.
• To emphasize the benign prognosis associated with idiopathic hyperCKemia.

Main Methods:

• Case report of a 61-year-old Caucasian female presenting with asymptomatic hyperCKemia.
• Comprehensive diagnostic workup including physical examination, laboratory tests, electromyography, and muscle biopsy.
• Long-term clinical and biochemical monitoring over two years.

Main Results:

• The patient presented with a serum CK (sCK) level of 6,122 IU/l, over 50-fold higher than normal.
• Extensive diagnostic evaluations ruled out neuromuscular, cardiac, metabolic, endocrine, and traumatic disorders.
• After two years, the patient remained asymptomatic with persistently elevated sCK levels (≤6,591 IU/l).

Conclusions:

• Idiopathic hyperCKemia can manifest as markedly elevated sCK levels in asymptomatic individuals.
• A thorough diagnostic evaluation is crucial to exclude other underlying pathologies.
• The case supports the generally benign prognosis of idiopathic hyperCKemia, even with extreme elevations in sCK levels.