Creatine Kinase - Causes of Elevated CK Levels
Acute CK Elevation (Pain > Weakness):
• RHABDOMYOLYSIS
- Drugs: cocaine, amphetamines, alcohol
- Medications: statins, fibrates, colchicine, daptomycin
- Illness: viral (COVID19, CMV/EBV, HIV), clostridial spp, mycoplasma, staph, strep)
- Seizures: Trauma, burns, hyperthermia, immobility
• Critical Illness Myopathy (ICU, steroids, mechanical ventilation)
• Myocardial infarction, Acute renal injury, Strenuous exercise
Subacute to Chronic Causes (Weakness > Pain):
• PROXIMAL MUSCLE WEAKNESS
- Endocrine: Hypo/hyperthyroidism, acromegaly
- Electrolytes: hypo- phos, kalemia, calcemia, natremia
- Muscular dystrophy
- Metabolic Myopathies
- Neuromuscular disorders
- Vit D/E deficiency
- Medications- Statins, fibrates, colchicine, daptomycin
- Chronic Illness: HIV, Trichinella, toxoplasmosis
- Inflammatory myopathy: dermatomyositis, polymyositis, necrotizing myopathy
- Autoimmune: mixed connective tissue disorder, SLE
• PROXIMAL AND DISTA: Inclusion body myositis
• ASYMPTOMATIC: Macro CK
Ann Marie Kumfer @AnnKumfer
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