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Re: elevated cpk

Posted By CCF neuro MD MM on November 01, 1998 at 14:11:51:

In Reply to: elevated cpk posted by ss on November 01, 1998 at 08:39:39:

A couple of years ago, through a blood test, I found out that my cpk was elevated. I has averaged at about 1,000. I had an EMG done. The results were neg. My family dr. decided to moniter the levels every few months.
It was determined that the elevated part of the cpk is from muscle.
  A couple of months ago, I had chest pains. After extensive tests it was determined that it was not my heart. My cpk was3900. I was not having any pain at the time of the test. I was sent to a specialist who did a muscle biopsy. The only other symptom is tight sore calf muscles in the morning.
  My biopsy showed fattty deposits in the muscle. It has been over 2 months now and they have sent the muscle off for more testing.  My family doctor doesn't feel there is anything wrong.My mom died from a heart attack at 32 and he said this is why they are doing more testing. I can't find anything on this subject. Does fat in muscle have anything to do with cpk level and pain in calves?

The problems you describe suggest the possibility of a disease of skeletal muscle
- a myopathy.
CK is found in three tissues , skeletal muscle, heart and brain, it is
relatively easy to decide in any given case where the excess CK is coming
from although if some one comes into the ER with chest pain and a high CK
it is always a cause for concern.
If your CK is always elevated it really does provide reassurance that it really id form ske;letal muscle.
The finding of fatty tissue in a muscle biopsy is described in a number of
muscle diseases and suugeests that muscle fibers have degenerated and
have bben replaced by fatty tissue, further, although non-specific
evidence of a myopathy.
Calf muscle soreness could be related although again this is not
sufficiently specific to isolated the problem further.
As regard the next step, you do have evidence that there may be a myopathy,
this group of diseasea while very serious in childhood tend not to be very
severe or even asymptomatic in adulthood.
It would appear that the correct steps are being followed in sending the
muscle tissue for further analysis,these tests are fairly infrequently
performed, and a wait of severweeks in not uncommon.
I would suggest that you look for a second opinion from a neurologist who
subspecializes in muscle disorders if you do not recieve a definitive diagnosis from ythe present round of testing.
It may well be that it is not going to be possible to attach a label to your problem since many muscle disease are
only beginning to be clarified regarding their causes and classification.
It is frequently not possible to give a label to many people with raised
CPK because the underlying pathological mechanisms have not yet been

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