title: Myocardial specific creatine phosphokinase isoenzyme elevation in children with asthma treated with intravenous isoproterenol.
abstract: We retrospectively reviewed admissions that required intravenous (IV) isoproterenol in an intensive care unit setting for management of severe childhood status asthmaticus. Elevation of the cardiac-specific serum creatine phosphokinase MB (CPK-MB) isoenzyme was noted in 15 of 19 admissions. The mean peak elevation of serum CPK in those 15 admissions was 204 IU/L with a mean peak MB band of 6.05%. Nine of the 15 admissions with elevated CPK-MB level had follow-up levels measured after IV isoproterenol had been stopped. In all nine cases, the follow-up serum CPK-MB level was 0%. In six of those nine cases, follow-up serum with undetectable CPK-MB level was obtained while the patients continued to receive IV aminophylline and corticosteroids, and inhaled but not intravenous beta-adrenergic agonist medications. These observations suggest that elevated serum CPK-MB levels that may be indicative of myocardial injury are associated with IV isoproterenol therapy of severe childhood asthma. Therefore, we recommend caution along with serial monitoring of serum CPK-MB levels when IV isoproterenol is administered in the therapy of childhood asthma.
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000188:drug therapy / Q000201:enzymology*; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007527:Isoenzymes; D007545:Isoproterenol / Q000009:adverse effects*; D008297:Male; D009206:Myocardium / Q000201:enzymology
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase; D007545:Isoproterenol