Asymptomatic hyperCKemia during a two‑year monitoring period: A case report and literature overview

Klinis,Spyridon; Symeonidis,Athanasios; Karanasios,Dimitrios; Symvoulakis,Emmanouil K.

doi:10.3892/br.2016.822

Asymptomatic hyperCKemia during a two‑year monitoring period: A case report and literature overview

Authors:
- Spyridon Klinis
- Athanasios Symeonidis
- Dimitrios Karanasios
- Emmanouil K. Symvoulakis
View Affiliations

Affiliations: Primary Health Care Unit of Alonakia, Kozani 50100, Greece, New Mihaniona Primary Health Center, Thessaloniki 57004, Greece, Hippocrates, Association of General Practice/Family Medicine of Greece, Athens 11525, Greece, Private Family Practice Unit in Heraklion, Heraklion 71304, Greece
Published online on: November 30, 2016 https://doi.org/10.3892/br.2016.822
Pages: 79-82

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

High creatine kinase (CK) levels can be associated with many disorders, including neuromuscular, cardiac, metabolic, endocrine and traumatic. Idiopathic hyperCKemia is a diagnostic dilemma for physicians even though its long‑term prognosis is usually benign. We report a case of a Caucasian 61‑year‑old woman who presented as completely asymptomatic to her general practitioner with a serum CK (sCK) level at 6,122 IU/l. A complete diagnostic evaluation, including physical and laboratory examinations, electromyogram and muscle biopsy were negative for any neuromuscular or other disorder. Two years later the patient remains asymptomatic, active and overall healthy but sCK levels remain elevated, ≤6,591 IU/l (>50‑fold higher than normal values).

View Figures

View References

1	Nanji AA: Serum creatine kinase isoenzymes: A review. Muscle Nerve. 6:83–90. 1983. View Article : Google Scholar : PubMed/NCBI
2	Silvestri NJ and Wolfe GI: Asymptomatic/pauci-symptomatic creatine kinase elevations (hyperckemia). Muscle Nerve. 47:805–815. 2013. View Article : Google Scholar : PubMed/NCBI
3	Wong ET, Cobb C, Umehara MK, Wolff GA, Haywood LJ, Greenberg T and Shaw ST Jr: Heterogeneity of serum creatine kinase activity among racial and gender groups of the population. Am J Clin Pathol. 79:582–586. 1983. View Article : Google Scholar : PubMed/NCBI
4	Kyriakides T, Angelini C, Schaefer J, Sacconi S, Siciliano G, Vilchez JJ and Hilton-Jones D: European Federation of Neurological Societies: EFNS guidelines on the diagnostic approach to pauci- or asymptomatic hyperCKemia. Eur J Neurol. 17:767–773. 2010. View Article : Google Scholar : PubMed/NCBI
5	Brewster LM, Mairuhu G, Sturk A and van Montfrans GA: Distribution of creatine kinase in the general population: Implications for statin therapy. Am Heart J. 154:655–661. 2007. View Article : Google Scholar : PubMed/NCBI
6	Prelle A, Tancredi L, Sciacco M, Chiveri L, Comi GP, Battistel A, Bazzi P, Boneschi F Martinelli, Bagnardi V, Ciscato P, et al: Retrospective study of a large population of patients with asymptomatic or minimally symptomatic raised serum creatine kinase levels. J Neurol. 249:305–311. 2002. View Article : Google Scholar : PubMed/NCBI
7	Kaushik P and Gonuguntla A: Idiopathic Benign Hyper-CK-Emia. Int J Biomed Sci. 5:79–80. 2009.PubMed/NCBI
8	Rowland LP, Willner J, DiMauro S and Miranda A: Approaches to the membrane theory of Duchenne muscular dystrophyMuscular dystrophy-advances and new trends. Angelini C, Danieli GA and Fontarni D: Excerpta Medica; Amsterdam: pp. 3–13. 1980
9	Capasso M, De Angelis MV, Di Muzio A, Scarciolla O, Pace M, Stuppia L, Comi GP and Uncini A: Familial idiopathic hyper-CK-emia: An underrecognized condition. Muscle Nerve. 33:760–765. 2006. View Article : Google Scholar : PubMed/NCBI
10	Brewster LM and de Visser M: Persistent hyperCKemia: Fourteen patients studied in retrospect. Acta Neurol Scand. 77:60–63. 1988. View Article : Google Scholar : PubMed/NCBI
11	Reijneveld JC, Notermans NC, Linssen WH and Wokke JH: Benign prognosis in idiopathic hyper-CK-emia. Muscle Nerve. 23:575–579. 2000. View Article : Google Scholar : PubMed/NCBI
12	D'Adda E, Sciacco M, Fruguglietti ME, Crugnola V, Lucchini V, Martinelli-Boneschi F, Zecca C, Lamperti C, Comi GP, Bresolin N, et al: Follow-up of a large population of asymptomatic/oligosymptomatic hyperckemic subjects. J Neurol. 253:1399–1403. 2006. View Article : Google Scholar : PubMed/NCBI
13	Fernandez C, de Paula AM, Figarella-Branger D, Krahn M, Giorgi R, Chabrol B, Monfort MF, Pouget J and Pellissier JF: Diagnostic evaluation of clinically normal subjects with chronic hyperCKemia. Neurology. 66:1585–1587. 2006. View Article : Google Scholar : PubMed/NCBI
14	Dabby R, Sadeh M, Herman O, Berger E, Watemberg N, Hayek S, Jossiphov J and Nevo Y: Asymptomatic or minimally symptomatic hyperCKemia: Histopathologic correlates. Isr Med Assoc J. 8:110–113. 2006.PubMed/NCBI
15	Joy JL and Oh SJ: Asymptomatic hyper-CK-emia: An electrophysiologic and histopathologic study. Muscle Nerve. 12:206–209. 1989. View Article : Google Scholar : PubMed/NCBI
16	Weglinski MR, Wedel DJ and Engel AG: Malignant hyperthermia testing in patients with persistently increased serum creatine kinase levels. Anesth Analg. 84:1038–1041. 1997. View Article : Google Scholar : PubMed/NCBI
17	Tachi N, Wakai S, Yutoh Y, Chiba S and Miura J: Asymptomatic hyperCKemia: Detection of an isolated carrier of Duchenne muscular dystrophy. J Child Neurol. 5:351–353. 1990. View Article : Google Scholar : PubMed/NCBI
18	Chen D and Che G: Value of caveolin-1 in cancer progression and prognosis: Emphasis on cancer-associated fibroblasts, human cancer cells and mechanism of caveolin-1 expression (Review). Oncol Lett. 8:1409–1421. 2014.PubMed/NCBI
19	Song KS, Scherer PE, Tang Z, Okamoto T, Li S, Chafel M, Chu C, Kohtz DS and Lisanti MP: Expression of caveolin-3 in skeletal, cardiac, and smooth muscle cells. Caveolin-3 is a component of the sarcolemma and co-fractionates with dystrophin and dystrophin-associated glycoproteins. J Biol Chem. 271:15160–15165. 1996. View Article : Google Scholar : PubMed/NCBI
20	Gazzerro E, Sotgia F, Bruno C, Lisanti MP and Minetti C: Caveolinopathies: From the biology of caveolin-3 to human diseases. Eur J Hum Genet. 18:137–145. 2010. View Article : Google Scholar : PubMed/NCBI
21	Carbone I, Bruno C, Sotgia F, Bado M, Broda P, Masetti E, Panella A, Zara F, Bricarelli FD, Cordone G, et al: Mutation in the CAV3 gene causes partial caveolin-3 deficiency and hyperCKemia. Neurology. 54:1373–1376. 2000. View Article : Google Scholar : PubMed/NCBI
22	Reijneveld JC, Ginjaar IB, Frankhuizen WS and Notermans NC: CAV3 gene mutation analysis in patients with idiopathic hyper-CK-emia. Muscle Nerve. 34:656–658. 2006. View Article : Google Scholar : PubMed/NCBI
23	Merlini L, Carbone I, Capanni C, Sabatelli P, Tortorelli S, Sotgia F, Lisanti MP, Bruno C and Minetti C: Familial isolated hyperCKaemia associated with a new mutation in the caveolin-3 (CAV-3) gene. J Neurol Neurosurg Psychiatry. 73:65–67. 2002. View Article : Google Scholar : PubMed/NCBI