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Neurology (Expert Forum)
high CK
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high CK
by guido, Jun 04, 2004 12:00AM
Active, healthy 61 yr. male. Take no meds. In 1999 routine physical CK inadvertently checked 5400. First time ever tested. ALt-124, AST-130. Other blood tests and EKG normal. No physical problems at time except some chronic back problems and fasics in legs. ALT/AST up since '97. No prior baseline before then. Liver biopsy, CT of liver, ERCP, and EGD done-all normal. Other tests 1999: C-ANCA, P-ANCH, ANA, hepatitis ABC, & iron-bonding-all neg. Aldolase-15.9, LDH-336, CK-MM-high; CK-BB, CK-MB, T4, TSH, and copper oxilase-all normal. No dx.
Then referred to rheumatologist and neuro. MRI leg muscles & some spinal areas, EMG, McArdles-neg, CK 5600, Kennedy's neg. MRI of back-herniated disk C8, problems L4/L5 from previous ruptured disk. No dx.
Sent to neuro spec. in muscular diseases. EMG (abnormalities possibly due to multiple spine compressions. Nerve velocity normal, and tests for known muscle diseases. Muscle biopsy showed no known musc. disease. Final dx- Hyper CK due to slow non inflammatory myopathy. Dr's opinion-had all life?
Since '99 musc. strength tests near same-most in 4+ to 5 range. CK 4000-6000. ALT up 332/AST 268. Still active, little if any weakness, change. No fasics, some chronic back problems.
Greatest concern:4/04 CK-7400 and 5/04-10,500; ALT/AST same during routine physical. Could this sudden increase indicate the acceleration of this disease? Can CK fluctuate this much w/o significant meaning? How high can CK rise without causing sig. weakness, or can it reach point where body can't rebuild damaged muscle? Another dx possible?
Then referred to rheumatologist and neuro. MRI leg muscles & some spinal areas, EMG, McArdles-neg, CK 5600, Kennedy's neg. MRI of back-herniated disk C8, problems L4/L5 from previous ruptured disk. No dx.
Sent to neuro spec. in muscular diseases. EMG (abnormalities possibly due to multiple spine compressions. Nerve velocity normal, and tests for known muscle diseases. Muscle biopsy showed no known musc. disease. Final dx- Hyper CK due to slow non inflammatory myopathy. Dr's opinion-had all life?
Since '99 musc. strength tests near same-most in 4+ to 5 range. CK 4000-6000. ALT up 332/AST 268. Still active, little if any weakness, change. No fasics, some chronic back problems.
Greatest concern:4/04 CK-7400 and 5/04-10,500; ALT/AST same during routine physical. Could this sudden increase indicate the acceleration of this disease? Can CK fluctuate this much w/o significant meaning? How high can CK rise without causing sig. weakness, or can it reach point where body can't rebuild damaged muscle? Another dx possible?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Jun 08, 2004 12:00AM
It sounds like you had a very extensive evaluation when this diagnosis was initially established. However, your current levels of CK would seem to high to be explained by hyper CK. Excercise and medication would need to be excluded as a possibility for the change. If these have not changed, it may be worth while to do some re-investigation. If you do this, I would recommend obtaining all your old records and having a consult at a large academic center. If you are in the area, we have many experienced neuromuscular specialists. Good luck.
