Paul Collinson wrote:
>
> The CK/CK-MB ratio is unreliable
>
> see
>
> Collinson PO, Chandler HA, Stubbs PJ, Moseley D, Lewis D, Simmons MD.
> Measurement of cardiac troponin T and CK-MB concentration for the differential
> diagnosis of elevated creatine kinase following arduous physical training. Ann
> Clin Biochem 1995; 32: 450-3
>
> A tumour is as rare as rare can be
> --
> Paul Collinson
So where are we? We agree that the cause is most likely NOT of cardiac origin
because of the negative TnI and TnT results. I will agree that the CKMB/tCK ratio
can be unreliable, but unless our 93 year old female is a marathon runner or
weight lifter, and without a documented rhabdomyolysis, I still can't assume a
skeletal muscle source as the explanation. I guess what this all says is that
laboratory tests alone do not a diagnosis make.
maurice green, phd
clinical chemist
stanford hospital
palo alto, ca
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