[False increased CK-MB value after cryoablation of the prostate without myocardial infarct].
The authors report on a profound increase in creatine kinase isoenzyme MB (CK-MB) activity in three patients following uneventful cryoablation of the prostate under general anaesthesia: Just after the arrival at the recovery room CK-MB levels were 321 U/l, 245 U/l and 433 U/l, respectively. Other clinical investigations as well as additional laboratory tests ruled out myocardial infarction in all three patients. Electrophoresis of the CK-isoenzymes revealed an increase in CK-BB activity and an increase in atypical CK-BB as a cause of these findings. The presence of these isoenzymes leading to interferences with the antibody commonly used in CK-MB assays could explain the determination of a false positive CK-MB elevation in the three patients. Moreover, it is shown that this method of CK-MB activity determination may result in CK-MB levels higher than 100% of the whole CK activity. In addition, it is discussed that in patients suffering from prostatic carcinoma or other malignoma, "non-CK-M elevations" may occur. Therefore, the authors conclude that after cryoablation of the prostate additional tests like troponin T test and 12 channel ECG are required to rule out suspected myocardial infarction.
Gries
A
A
Klinik für Anästhesiologie, Ruprecht-Karls-Universität, Heidelberg.
Werle
E
E
Wiesel
M
M
Martin
E
E
D000368:Aged; D000768:Anesthesia, General; D003402:Creatine Kinase / Q000097:blood*; D003452:Cryosurgery; D003951:Diagnostic Errors; D005189:False Positive Reactions; D006801:Humans; D007527:Isoenzymes; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000201:enzymology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000201:enzymology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000201:enzymology / Q000601:surgery*; D012680:Sensitivity and Specificity
D007527:Isoenzymes; D003402:Creatine Kinase