16 year old boy presented to GP approx 1 year ago with some shortness of
breath, muscle pains. He has been seen in various specialities, no
abnormality being found, and the GP was told the muscle biopsy was "normal".
The GP outrules drug abuse and muscle building regimes. He is euthyroid and
on no medication. He has had 3 transient rises in AST (highest 112 U/L) over
7 months, mirrored to a lesser extent by ALT (highest 90 U/L). Alk Phos is
constantly elevated at 300 - 400 U/L, but he would be still growing. GGT has
remained normal". 24 hours post excercise his CPK was 4451 U/L, AST 112, ALT
64 U/L. His CPK during the first 7 month period was 899 in May, 1092 in
July, 1873 in August, 636 on 3/9/01, and 1579 on 20/9/01, then 4451 in
December post excercise, and recently while in hospital was 309 U/l, by
which time AST and ALT were also normal.
Any comments or suggestions?
Dr Helen Grimes
Department of Clinical Biochemistry
University College Hospital
Galway
Ireland
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