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Creatinine Kinase (CK, CPK) is an enzyme found primarily in the heart and skeletal muscles, and to a lesser extent in the brain. Significant injury to any of these structures will lead to a measurable increase in CK levels.
Elevations found in:
Myocardial infarction
Crushing muscular trauma
Any cardiac or muscle disease, but not myesthenia gravis or multiple sclerosis
Brain injury
Hypothyroidism
Hypokalemia
Once elevated, CK remains elevated for several days, if the injury is acute.
If there is on-going injury, the CK will remain elevated indefinitely.
Note:
In acute MI, CK usually rises faster than SGOT and returns to normal faster than the SGOT.
CK/CPK Isoenzymes
There are three Isoenzymes. Measuring them is of value in the presence of elevated levels of CK or CKP to determine the source of the elevation.
Isoenzyme
MM
BB
MB
Synonym
CK3
CK1
CK2
Found in:
Skeletal M. Heart M.
Brain GI Tract GU Tract
Heart M.
Normal levels of CK/CPK are almost entirely MM, from skeletal muscle.
Elevated levels of CK/CPK resulting from acute myocardial infarction are about half MM and half MB
Normal Values for CK, CPK*
Men
5-100 IU/L
Women
10-70 IU/L
Pregnancy
5-40 IU/L
Normal Values for CK or CPK Isoenzymes*
MM
97%-100%
MB
0%-3%
BB
0%
*These are general values taken from a variety of sources. The actual normal values may vary from lab to lab and from one type of testing protocol to another.
Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300
