Immunoglobulin-associated creatine kinase masquerading as macro-creatine kinase type 2 in a statin user

Intern Med. 2012;51(9):1061-4. doi: 10.2169/internalmedicine.51.7157. Epub 2012 Apr 29.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Creatine Kinase / blood*
  • Electrophoresis, Gel, Two-Dimensional
  • False Positive Reactions
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Immunoglobulin G / blood*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunoglobulin G
  • Creatine Kinase