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Dermatomyositis without creatine kinase elevation. A poor prognostic sign.
The American Journal of Medicine
|February 1, 1986
Summary
Normal creatine kinase levels in dermatomyositis patients indicate a poor prognosis. This finding is linked to associated malignancy or severe lung disease, significantly impacting survival rates in these inflammatory myopathy cases.
Area of Science:
- Rheumatology
- Neurology
- Oncology
Background:
- Inflammatory myopathies, including polymyositis and dermatomyositis, typically present with elevated serum muscle enzymes.
- Creatine kinase (CK) is a primary biomarker for diagnosing these conditions.
Observation:
- This study describes seven dermatomyositis patients with normal creatine kinase levels.
- Five of these seven patients exhibited concurrent malignancy or severe interstitial lung disease.
Findings:
- A lack of elevated creatine kinase in dermatomyositis is a significant indicator of a poor prognosis.
- The one-year survival rate for the six patients with available follow-up data was only 33 percent.
Implications:
- Normal CK levels in dermatomyositis warrant thorough investigation for underlying malignancy or lung disease.
- This highlights the need for alternative diagnostic and prognostic markers beyond creatine kinase in specific dermatomyositis cases.