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Ono R, Okada S, Aoki K, Kato H, Iwahana T, Kobayashi Y. Transthyretin amyloidosis with macro-creatine kinase. BMJ Case Rep 2022; 15:e251209. [PMID: 35793855 PMCID: PMC9260768 DOI: 10.1136/bcr-2022-251209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ryohei Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
| | - Sho Okada
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
| | - Kaoruko Aoki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
| | - Hirotoshi Kato
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
| | - Togo Iwahana
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine School of Medicine, Chiba, Japan
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2
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Lin YJ, Chang LW, Hung SC. Macro-Ck type 2 syndrome in prostate adenocarcinoma: Case report and review article. Urol Case Rep 2021; 39:101805. [PMID: 34430214 PMCID: PMC8365386 DOI: 10.1016/j.eucr.2021.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 10/27/2022] Open
Abstract
A 67-year-old male had prostate adenocarcinoma with liver, bone metastases, iliac lymph nodes invasion ever receive hormone and chemotherapy. He was presented to our emergency department with acute onset of mild dizziness and shortness of breath. Elevated CK (1477 U/L) and elevated CK-MB (1602 U/L) was noticed. Electrocardiogram was unremarkable for myocardial ischemia. CK-isoenzyme lab test (electrophoresis) was obtained, which revealed macro CK type 2 accounting for 6.2% of total CK. Type 2 macro CK syndrome was impressed. The falsely elevated CK-MB and macro CK type 2 in serum may be associated with the patient's worsening metastatic disease.
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Affiliation(s)
- Yu-Ju Lin
- Department of Education, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Wen Chang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Sheng-Chun Hung
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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3
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Zhang L, Han F, Liu X, Xie C, Tian K, Bi Q, Hao M, Mu X. Macro creatine kinase in an asymptomatic patient: a case report. Clin Chem Lab Med 2020; 59:e61-e64. [PMID: 32759404 DOI: 10.1515/cclm-2020-0811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/24/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Lei Zhang
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
| | - Fengjuan Han
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
| | - Xiao Liu
- Department of Laboratory Medicine, Qingdao Eight People Hospital, Qingdao, P.R. China
| | - Chunxia Xie
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
| | - Kegang Tian
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
| | - Qingqing Bi
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
| | - Mingju Hao
- Department of Laboratory Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, P.R. China
| | - Xiaofeng Mu
- Department of Laboratory Medicine, Qingdao Central Hospital, Second Affiliated Hospital of Qingdao University, Siliunan Road #127, Qingdao, 266042 P.R. China
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4
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Eidizadeh A, von Ahsen N, Friedewald S, Binder L. Macro-CK type 2 in metastatic prostate cancer. Diagnosis (Berl) 2019; 6:307-309. [PMID: 30412465 DOI: 10.1515/dx-2018-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/11/2018] [Indexed: 11/15/2022]
Abstract
The isoenzyme creatine kinase muscle/brain (CK-MB) still plays an important role for the differential diagnosis of CK elevations and the clarification of their origin from heart or skeletal muscle. Therefore, it is necessary to know the diagnostic pitfalls in interpreting CK-MB results. We demonstrate a case of macro-CK type 2 in a 75-year-old patient with metastatic castration-resistant prostate cancer and its identification by isoenzyme electrophoresis, which can be typical for cancer diseases.
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Affiliation(s)
- Abass Eidizadeh
- Universitätsmedizin Göttingen, Georg-August-Universität Göttingen, Institut für Klinische Chemie, Robert-Koch-Str. 40, 37075 Göttingen, Germany, Phone: 0551 39-8549
| | - Nicolas von Ahsen
- Institute for Clinical Chemistry, University Medical Center Goettingen, Goettingen, Germany
| | - Steffen Friedewald
- Institute for Laboratory Diagnostics, Elbe Kliniken Stade-Buxtehude, Stade, Germany
| | - Lutz Binder
- Institute for Clinical Chemistry, University Medical Center Goettingen, Goettingen, Germany
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Abstract
With an ever aging population, identifying interventions that can alleviate age-related functional declines has become increasingly important. Dietary supplements have taken center stage based on various health claims and have become a multi-million dollar business. One such supplement is creatine, a major contributor to normal cellular physiology. Creatine, an energy source that can be endogenously synthesized or obtained through diet and supplement, is involved primarily in cellular metabolism via ATP replenishment. The goal of this chapter is to summarize how creatine and its associated enzyme, creatine kinase, act under normal physiological conditions, and how altered levels of either may lead to detrimental functional outcomes. Furthermore, we will focus on the effect of aging on the creatine system and how supplementation may affect the aging process and perhaps reverse it.
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Affiliation(s)
- Nathalie Sumien
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Ritu A Shetty
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Eric B Gonzales
- Department of Medical Education, TCU and UNTHSC School of Medicine, Fort Worth, TX, USA.
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Ombrato A, Manzi AV, Palmieri D, Ferrara K, Catalano L, Savoia M. Multiple myeloma and macro creatine kinase type 1: the first case report. Clin Chem Lab Med 2018; 56:e239-e242. [PMID: 29652663 DOI: 10.1515/cclm-2018-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/09/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Ombrato
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Valerio Manzi
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Daniela Palmieri
- Department of Laboratory Medicine, University of Naples Federico II, Naples, Italy
| | - Katia Ferrara
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Lucio Catalano
- Department of Clinical Medicine, University of Naples Federico II, Naples, Italy
| | - Marcella Savoia
- Department of Laboratory Medicine, University of Naples Federico II, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
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7
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Elevación persistente de lactato deshidrogenasa de etiología incierta en enfermedad de Graves. ENDOCRINOL DIAB NUTR 2018; 65:374-375. [DOI: 10.1016/j.endinu.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 02/25/2018] [Accepted: 03/02/2018] [Indexed: 11/20/2022]
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Horino T, Ichii O, Ode-Hamada K, Terada Y. Macromolecular creatine kinase type 1 in immune-mediated necrotizing myopathy. QJM 2017. [PMID: 28633310 DOI: 10.1093/qjmed/hcx113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Horino
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - O Ichii
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-Ku, Sapporo 060-0818, Japan
| | - K Ode-Hamada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
| | - Y Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan
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Aljuani F, Tournadre A, Cecchetti S, Soubrier M, Dubost JJ. Macro-creatine kinase: a neglected cause of elevated creatine kinase. Intern Med J 2015; 45:457-9. [DOI: 10.1111/imj.12710] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- F. Aljuani
- Department of Rheumatology; G. Montpied Hospital; Clermont-Ferrand University; Clermont-Ferrand France
| | - A. Tournadre
- Department of Rheumatology; G. Montpied Hospital; Clermont-Ferrand University; Clermont-Ferrand France
| | - S. Cecchetti
- Department of Rheumatology; G. Montpied Hospital; Clermont-Ferrand University; Clermont-Ferrand France
| | - M. Soubrier
- Department of Rheumatology; G. Montpied Hospital; Clermont-Ferrand University; Clermont-Ferrand France
| | - J. J. Dubost
- Department of Rheumatology; G. Montpied Hospital; Clermont-Ferrand University; Clermont-Ferrand France
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10
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Kim S, Um TH, Cho CR, Jeon JS. False-positive elevation of creatine kinase MB mass concentrations caused by macromolecules in a patient who underwent nephrectomy for renal cell carcinoma. Ann Lab Med 2014; 34:405-7. [PMID: 25187898 PMCID: PMC4151014 DOI: 10.3343/alm.2014.34.5.405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 02/24/2014] [Accepted: 06/26/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sollip Kim
- Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Hyun Um
- Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Chong-Rae Cho
- Department of Laboratory Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Joon-Seong Jeon
- Department of Urology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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11
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Bodensteiner JB. Macro creatine kinase type 1: a cause of spuriously elevated serum creatine kinase associated with leukoencephalopathy in a child. J Child Neurol 2014; 29:973-6. [PMID: 23625087 DOI: 10.1177/0883073813484805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 03/07/2013] [Indexed: 11/16/2022]
Abstract
Macro creatine kinase type 1 is a complex formed by the creatine kinase isoenzyme BB and monoclonal IgG and occurs in about 1% of patients studied. First identified as a cause of spurious elevation of the total serum creatine kinase in patients suspected of myocardial infarction, the test has been largely replaced by the measurement of troponin levels. We present a child with delayed milestones and persistently elevated total serum creatine kinase measurements (∼ 1000-4000 IU) normal electromyogram and brisk myotatic reflexes. Creatine kinase isoenzymes and brain imaging showed the presence of macro creatine kinase type 1 and extensive signal abnormality of the cerebral white matter. Macro creatine kinase type 1 has been associated with several conditions though it has not been described in association with leukoencephalopathy or in patients this young. Macro creatine kinase type 1 can be a cause of elevated total creatine kinase in patients without primary muscle disease. The significance of the relationship of the macro creatine kinase to the leukoencephalopathy in this patient is unknown.
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12
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Creatine-kinase- and exercise-related muscle damage implications for muscle performance and recovery. J Nutr Metab 2012; 2012:960363. [PMID: 22288008 PMCID: PMC3263635 DOI: 10.1155/2012/960363] [Citation(s) in RCA: 339] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 09/06/2011] [Accepted: 09/28/2011] [Indexed: 01/08/2023] Open
Abstract
The appearance of creatine kinase (CK) in blood has been generally considered to be an indirect marker of muscle damage, particularly for diagnosis of medical conditions such as myocardial infarction, muscular dystrophy, and cerebral diseases. However, there is controversy in the literature concerning its validity in reflecting muscle damage as a consequence of level and intensity of physical exercise. Nonmodifiable factors, for example, ethnicity, age, and gender, can also affect enzyme tissue activity and subsequent CK serum levels. The extent of effect suggests that acceptable upper limits of normal CK levels may need to be reset to recognise the impact of these factors. There is a need for standardisation of protocols and stronger guidelines which would facilitate greater scientific integrity. The purpose of this paper is to examine current evidence and opinion relating to the release of CK from skeletal muscle in response to physical activity and examine if elevated concentrations are a health concern.
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Detection of macro-creatine kinase and macroamylase by polyethylene glycol precipitation and ultrafiltration methods. Clin Chim Acta 2011; 412:2052-7. [DOI: 10.1016/j.cca.2011.01.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/19/2011] [Accepted: 01/20/2011] [Indexed: 11/21/2022]
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