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Neurology (Expert Forum)
Elevated CPK
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Elevated CPK
by Yan 2, Feb 14, 2004 12:00AM
I'm a 26 y.o l male diagnosed last year for benign fasciculations syndrome. I take for anxiety and BFS Lamictal 100mg and Effexor 75mg/day. In january I had influenza-like virus with fever, followed by 3 weeks light sore troat and again a pharyngitis that begun last friday. Saturday morning I felt leg cramps in my calf starting when I was walking and increasing as I walked further. This fall I've been particularly active for I started conditioning (weight lift and aerobics). The last time I went to gym was thurday.
I took Zithromax antibiotics saturday (after the cramp), at the rate of 2 X 250mg for 4 days to clear the pharyngitis. The cramps were still there monday, so I went to a clinic and got blood tested. Cpk were at 1400. All the rest was normal: urine, ANA, sedimentation, white and red cells and minerals. Wednesday my CPK was at 2400. And finally friday they went down at 1180. The CPK rate seems to follow the cycle of the antibiotics, bur I'm really scared about a general condition. Last year an EMG was run and it was normal. I have no other symptoms except those leg cramps in my 2 calves. But it tend to decrase since yesterday. During the week my urine was normal all the time, no sign of myoglobinuries nor hyper/atrophy.
I saw on the internet that those medications could increase CPK, but allways on site for people infected with HIV. Does HIV has something to see with it or is it just the fact that it have been observed on HIV'ers because they take so much drugs ? My physician and my pharmacist think it's toxic (lamictal + effexor + zithromax). Do you think so ?
I took Zithromax antibiotics saturday (after the cramp), at the rate of 2 X 250mg for 4 days to clear the pharyngitis. The cramps were still there monday, so I went to a clinic and got blood tested. Cpk were at 1400. All the rest was normal: urine, ANA, sedimentation, white and red cells and minerals. Wednesday my CPK was at 2400. And finally friday they went down at 1180. The CPK rate seems to follow the cycle of the antibiotics, bur I'm really scared about a general condition. Last year an EMG was run and it was normal. I have no other symptoms except those leg cramps in my 2 calves. But it tend to decrase since yesterday. During the week my urine was normal all the time, no sign of myoglobinuries nor hyper/atrophy.
I saw on the internet that those medications could increase CPK, but allways on site for people infected with HIV. Does HIV has something to see with it or is it just the fact that it have been observed on HIV'ers because they take so much drugs ? My physician and my pharmacist think it's toxic (lamictal + effexor + zithromax). Do you think so ?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Feb 19, 2004 12:00AM
I could find no information to suggest that these medications would have caused the elevation of your muscle enzymes. However, I can not exclude that this is not the cause of your muscle enzyme change. However, it would be reasonable to have this re-evaluated/ followed. Other muscle enzymes such as aldolase can also be checked. Other markers of inflammation such as a CRP or sedimentation rate can also be checked. It is possible to have some muscle breakdown with some viral illnesses as well. An evaluation by a neurologist would be reasonable. Good luck.
