At 12:37 PM 8/6/00 -0400, Elizabeth Mac Namara wrote:
>I was wondering if you could help me I was refered a patient on whom his
>GP did a CK toal for somewhat spurious reasons and found it to be high
>about 3000 (about twenty times our upper limit of normal). He is
>essentially normal otherwise. Originally I was sure he would turn out to
>be a body builder or heavy manual worker. Al clues have been negative it
>is all muscualr in origin. He has no complaints, originally from
>Trinidad but has lived and worked in Canada for more than 10 years. He
>is 56 years of age and while he used to work out and play active sports
>he has not had this sort of activity for some years. I would appreciate
>any help you could give me especially if I am missing something very
>obvious.
>
In addition to the possibility of a race dependent reference interval
(although I thought this was only an incerase in reference interval by a
factor of 2) I would suggest checking the following:
1. From history: unextected exercise in the last 48 hours (eg gardening,
playing soccer with children etc) enough to give muscle stiffness.
2. Check thyroid status for hypothyroidism.
3. A macro CK (CK-BB - immunoglobulin complex). Tis can be seen with CK
electrophoresis. This (and 2) are probably not worth checking unless a
repeat CK measurement stays high.
Best wishes,
Graham
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney, Australia
Ph: (02) 9361-2170 Fax (02) 9361-2489
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