Creatine kinase activity in sickle cell disease.

Abstract

Creatine kinase activity was measured in 28 patients in the steady state of sickle cell disease and ranged from 4-45 IU/l, comparable with that found in healthy adult caucasians. Creatine kinase activity was also measured in 14 patients admitted consecutively for the treatment of vaso-occlusive sickle cell crises. Creatine kinase activity remained within the normal range in eight of these 14 patients throughout their admission; none had muscle pain or a chest syndrome. In the remaining six, three with muscle pain and three with a chest syndrome, increased activity was found on one or more days. A further 17 patients with vaso-occlusive sickle cell crises, associated with muscle pain, were studied. Creatine kinase activity was significantly raised in all 17, the mean creatine kinase activity for men was 578.8 IU/l and 210.6 IU/l for women, with the highest values (up to 1790 IU/l) found in those who had exercised before admission. Measurement of creatine kinase activity may therefore be a useful marker of muscle perturbation due to sickling.

Apolipoprotein A-I and serum amyloid A plasma levels are biomarkers of acute painful episodes in patients with sickle cell disease

“…19 In addition to hemolysing erythrocytes, ischemic bone marrow and other organs likely release lactate dehydrogenase during acute painful episodes, 20 and injured muscle tissue releases creatine kinase. 21 To our knowledge, our study is the first application of proteomic screening to the clinical problem of acute painful episodes. The SELDI-TOF platform is well-positioned to undertake high throughput analyses and identify candidate markers for further investigation by more validated assays, as in this study.…”

Serum Creatine Kinase: A Marker for Muscle Damage in Sickle Cell Painful Crisis

“…20,21 A Medline search revealed only one study relating sickle cell crisis and skeletal muscle injury evidenced by raised CK. In that study by Hunt et al, 8 a disproportionate number of patients with increased CK had a history of strenuous exercise before the onset of the painful crisis. None of the patients in our sample had exercised prior to the crisis.…”

“…Thus, it is possible that some patients with significant skeletal muscle damage may have been missed if the rise in CK occurred after the blood collection. In Hunt's study, 8 the samples at day one had a 25% false-negative rate. Severe muscle injury in sickle cell crisis can result from non-traumatic rhabdomyolysis with subsequent renal failure.…”

“…2,8 In this study, only the first blood samples taken at admission were used for CK estimation. The majority of our patients (60%) were given intramuscular injections in the ER after the blood sampling.…”

“…6,7 CK levels have now been used as a marker of muscle damage in a small number of patients in sickle cell crisis, but some of them had strenuous exercise before the onset of pain, and this may have vitiated some of the results. 8 Sickle cell disease is very common in the Eastern Province of Saudi Arabia, with the frequency of the trait ranging from 20% to 27% in some areas. 9 This study was initiated to use CK routinely in a larger series of patients with painful crises to verify the presence of muscle damage and its frequency, and to relate it to other clinical and biological parameters.…”