[Raised creatine-kinase serum activity: not necessarily a sign of disease].
Hyper-creatine-kinase(CK)-aemia in patients without neurological abnormalities may be sign of a subclinical neuromuscular disorder. Initial screening of patients with hyper-CK-aemia must include careful history taking and a neurological examination. Appropriate blood tests to exclude aeanthocytosis and glycogen storage disease type II must be done. The diagnostic value of a skeletal muscle biopsy and electromyography is small. A muscle biopsy to exclude dystrophinopathy is indicated if the CK activity exceeds 5 times the upper limit of the normal range. If the results of initial screening are normal, patients with idiopathic hyper-CK-aemia fare quite well at 7-year follow-up. Also, standardized exercise tests in these patients have provided no evidence of increased muscle vulnerability. Thus, in most of these patients, hyper-CK-aemia probably does not reflect disease.
Universitair Medisch Centrum Utrecht, afd. Neurologie, Postbus 85,500, 3508 GA Utrecht. j.wokke@neuro.azu.nl
J H
JH
Wokke
D001706:Biopsy; D003402:Creatine Kinase / Q000097:blood*; D003937:Diagnosis, Differential; D006801:Humans; D008487:Medical History Taking; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D012016:Reference Values
D003402:Creatine Kinase