Significance of elevated levels of serum creatine phosphokinase in febrile diseases: a prospective study.
The incidence and significance of elevated serum levels of creatine phosphokinase (CPK) in febrile diseases were studied prospectively in all patients admitted with fever to a department of medicine during 1 year. High serum CPK levels were detected in 70 (28%) of 247 febrile patients but in only six (6%) of 105 afebrile control patients (P = .0001). Elevated CPK levels were not related to any specific diagnosis. Logistic regression analysis identified five factors that correlated both significantly and independently with elevation of CPK values: increased blood urea nitrogen level, low serum phosphate level, a stuporous or comatose state, tremor, and muscle tenderness. Myoglobinuria, detected in 14 patients, was predictive of a fatal outcome, but a high CPK level by itself was not an independent correlate of mortality. In summary, CPK elevation is not uncommon in febrile diseases, but because it does not reflect a specific etiology it does not necessarily indicate that an extensive diagnostic work-up is required.
Cohen
O
O
Department of Internal Medicine B, Beilinson Medical Center, Petah Tiqva, Israel.
Leibovici
L
L
Mor
F
F
Wysenbeek
A J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D005334:Fever / Q000201:enzymology* / Q000209:etiology; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009212:Myoglobinuria / Q000201:enzymology; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000201:enzymology; D018805:Sepsis / Q000175:diagnosis / Q000201:enzymology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000201:enzymology
D003402:Creatine Kinase