Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Immunoglobulin-associated Creatine Kinase Masquerading as Macro-creatine Kinase Type 2 in a Statin User
Tze Ping Loh, Yan Hoon Ang, Siew Fong Neo, Cecilia Yin, Moh Sim Wong, Sai Mun Leong, Sharon Saw, Sunil K. Sethi
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Keywords: creatine kinase, immunoglobulin-associated, isoenzyme, macro-creatine kinase, mitochondrial creatine kinase
JOURNAL OPEN ACCESS

2012 Volume 51 Issue 9 Pages 1061-1064

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Abstract

Macro-creatine kinase (CK) is a cause of falsely elevated CK. Macro-CK type 1 is immunoglobulin-associated CK; type 2 is polymeric mitochondrial-CK. An elderly asymptomatic lady had an elevated CK level after receiving statin therapy. Her CK gel electrophoresis analysis demonstrated coexisting macro-CK type 1 and type 2 patterns. Further analysis by immunofixation and mixing this patient's serum with CK control material revealed an IgG-associated macro-CK that mimicked the electrophoretic pattern of macro-CK type 2. This highly unusual discovery suggests the possibility of the misinterpretation of macro-CK type 1 as macro-CK type 2. Falsely elevated CK is still common despite modern laboratory instrumentation and should be investigated.

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© 2012 by The Japanese Society of Internal Medicine
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