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We recently had a similar age customer on treatment for schizophrenia with CK in excess of 35,000 No clinical signs of myopathy. Already documented : http://www.nature.com/npp/journal/v15/n4/abs/1380485a.html results returned to previous baseline (1000) level when medication stopped temporarily. with best wishes Richard Richard Mainwaring-Burton Consultant Biochemist Queen Mary's Hospital Sidcup, Kent 020-8308-3084 Please note new e-mail address : [log in to unmask] ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of John Doran (ABMU NHS Trust - Biochemistry) Sent: 26 August 2009 10:58 To: [log in to unmask] Subject: Re: High CK - ?further investigation I would be suspicious of a metabolic myopathy and would review the patient for further investigation. John Doran Swansea ________________________________ From: Clinical biochemistry discussion list on behalf of Colley, Michael Sent: Wed 26/08/2009 10:49 To: [log in to unmask] Subject: Re: High CK - ?further investigation Most certainly. One of our technicians (yes it was that long ago) measured his CK before and after running a marathon. Although it had been normal before it was still in the tens of thousands next morning and returned to normal after several days. I would feel that no further investigation is needed. Michael Dr C M Colley Consultant Chemical Pathologist Great Western Hospital Swindon SN3 6BB -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Robert Lord Sent: 26 August 2009 10:33 To: [log in to unmask] Subject: High CK - ?further investigation Reviewing a set of medical notes today on a 24 yr old male who was admitted in July with a CK of 35,825. Swelling of both arms having spent all day laying slabs in his garden. Apparently had similar episode in Jan following exercise at gym. Otherwise well. Medication = inhalers for asthma. O/E muscles in both arms swollen and tender. Other tests - TSH = normal, CRP = normal, U+E = normal, FBC = normal, ALT = 165, LDH = 1243. Elevated urine myoglobin = 124 ug/L. Treated with iv fluids. CK = 7203 when discharged 3 days later. No follow up has been arranged. Do you see this kind of self induced increase in CK due to strenuous exercise or should I be suggesting follow up regarding investigation of a possible metabolic myopathy? Many thanks Rob ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. 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