Abstract:
The creatine kinase (CK) enzyme and its isoenzymes hold significant diagnostic value, appearing in distinct patterns across various tissues. The most common method for creatine kinase MB (CK-MB) estimation is based on immunoinhibition. However, this method can report falsely elevated CK-MB levels in various scenarios. Persistently elevated CK-MB levels or discrepancies between measured values and the patient\'s clinical condition warrant further investigation, such as total CK isoenzyme electrophoresis. This report presents a case where a patient was diagnosed with acute myocardial infarction and treated according to established guidelines. However, the presence of abdominal pain, in addition to persistently elevated CK-MB after the resolution of cardiac symptoms and a higher CK-MB to total CK ratio, suggested alternative pathologies. Thorough laboratory investigations, including quantitative CK isoenzyme electrophoresis and contrast-enhanced computed tomography (CECT) of the abdomen, followed by emergency operative intervention, led to a secondary diagnosis of acute small bowel infarction.
摘要:
肌酸激酶(CK)及其同工酶具有重要的诊断价值,在各种组织中以不同的模式出现。肌酸激酶MB(CK-MB)评估的最常见方法是基于免疫抑制。然而,这种方法可以在各种情况下报告CK-MB水平的错误升高。持续升高的CK-MB水平或测量值与患者临床状况之间的差异需要进一步调查。如总CK同工酶电泳。本报告介绍了一例患者被诊断为急性心肌梗塞并根据既定指南进行治疗的情况。然而,腹痛的存在,除了心脏症状消退后持续升高的CK-MB和更高的CK-MB占总CK的比率外,建议的替代病理。彻底的实验室调查,包括定量CK同工酶电泳和腹部对比增强计算机断层扫描(CECT),随后是紧急手术干预,导致急性小肠梗塞的二次诊断。