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Креатинкиназа МВ
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07.02.2013, 00:11
AlexT
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Creatine kinase MB (CKMB) values, which exceed 50% of the total CK, probably reflect unusual beta-subunit synthesis since the heart muscle rarely exceeds 30% CKMB.
The newer sandwich assays for CKMB have eliminated the confusion seen with older methodologies, but may result in the inability to detect some infrequent contributions to total CK (eg,
macro and mitochondrial forms
).
In patients receiving treatment with high biotin doses (>5 mg/day) there should be an interval of at least 8 hours between the last biotin administration and the collection of the specimen as biotin interferes with the assay.
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Rarely, under certain pathological conditions, abnormally increased
CK-BB may contribute to the falsely elevated CK-MB activity that may exceed total CK activity. Jap et al reported a patient with rectal adenocarcinoma and an
extremely high CK-MB activity greater than the total CK level
, in which the etiology was attributed to a marked elevated immunoglobulin-bound CK-BB complex (macro CK type 1) that was caused by the rectal cancer.
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An 82-year-old man presented with left chest pain and was found to have an
elevated creatine kinase MB (CK-MB) value greatly exceeding the total creatine kinase (CK) activity
. Subsequent electrophoresis showed that creatine kinase MM (CK-MM) accounted for 100% of the total CK activity. Eventually, the patient was diagnosed with prostatic adenocarcinoma (stage D)
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