title: [Differentiation of acute coronary syndrome and ulcerative colitis as causes of elevated macro creatine kinase in a patient with effort angina pectoris: a case report].
abstract: A 65-year-old man had been medically treated under a diagnosis of ulcerative colitis for 12 years as an outpatient at another facility. Two weeks before admission, he complained for the first time of mild chest pain limited to exertion. He was seen again by his previous physician in the morning and admitted to that facility later that day. Laboratory findings showed elevated serum creatine kinase (CK) at that time, so non-ST-elevated acute coronary syndrome was suspected and the patient was referred to our hospital. On admission, CK-MB was elevated but troponin T was negative. No findings of myocardial damage were observed during the admission period. Elective coronary angiography was performed and the diagnosis was effort angina pectoris. Elevated CK activity persisted but was not cardiogenic and instead due to the presence of elevated macro CK-1 associated with ulcerative colitis. Troponin T and isoenzyme electrophoresis were highly specific for the differential diagnosis of non-cardiogenic elevated CK.
authors.affiliation: Division of Cardiology, National Fukuoka Higashi Medical Center, Fukuoka.
authors.forename: Tomoka
authors.initials: T
authors.lastname: Yokoo
authors.forename: Takanobu
authors.initials: T
authors.lastname: Kawaharada
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujihara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hayashida
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsuoka
authors.forename: Yurika
authors.initials: Y
authors.lastname: Ooba
authors.forename: Akihiro
authors.initials: A
authors.lastname: Koike
mesh_terms: D000208:Acute Disease; D000787:Angina Pectoris / Q000150:complications* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis; D003402:Creatine Kinase / Q000097:blood*; D003937:Diagnosis, Differential; D015180:Electrophoresis, Gel, Two-Dimensional; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; D020107:Troponin T; D003402:Creatine Kinase