Macro creatine kinase type 2: results of a prospective study in hospitalized patients.

Abstract

We determined total CK activity with the N-acetylcysteine-activated method and residual activity after immunoinhibition of the CK-M subunits in the sera of 2018 patients consecutively admitted to our university hospital for internal diseases, and of 936 outpatients, regardless of the patients' diagnoses. We could detect not more than two types of macro CK: macro CK type 2, which we observed in the sera of 85 patients (prevalence, 3.7% for hospitalized patients), and macro CK type 1. Most patients showing macro CK type 2 were older than 50 years, but we additionally observed a second peak at 20-30 years of age. We saw no preponderance by sex. We detected macro CK type 2 predominantly in severely ill patients of all ages, mainly those with malignant tumors or cirrhosis of the liver. Our findings support the assumption that macro CK type 2 is the manifestation of mitochondrial CK in serum. Occasionally, macro CK type 2 disappeared from the circulation after amelioration of the associated disease. Its occurrence in serum nevertheless is a sign of a serious illness with high mortality but not inevitably a sign of impending death.

Macro‐creatine kinase: a neglected cause of elevated creatine kinase

“…Estimated prevalences are between 0.5% and 2.5% of hospitalised Brief Communications patients for CK type 1 and up to 3.7 % for CK type 2 in this same patient group. [4][5][6] Macro-CK type 1 does not have a clearly demonstrated pathological significance. It can occur in healthy subjects and also in association with varied pathologies, notably myositis, hypothyroidism or cardiovascular pathologies, conditions for which measurement of CK activity is frequently ordered.…”

“…7 Macro-CK type 2 is associated with diverse neoplasms, often metastatic and are believed to be released during cell lysis or produced by the tumour. 4,6 In observation 3, the patient had a neuroendocrine carcinoma with multiple metastases, some of which appeared necrotic on MRI. This macro-CK type is also associated with liver diseases notably cirrhosis.…”

“…This macro-CK type is also associated with liver diseases notably cirrhosis. 6 More recently, it has also been described in patients infected with human immunodeficiency virus and treated with antiretroviral agents. 8 It also occurs in children.…”

Increased serum mitochondrial creatine kinase activity as a risk for hepatocarcinogenesis in chronic hepatitis C patients

“…[10][11][12][13] In our previous report, we have observed that serum MtCK activity was also increased in patients with liver cirrhosis compared to healthy control although less prominent than in HCC patients. 8 In fact, an elevated serum MtCK activity was previously reported in patients with liver cirrhosis, 14 where MtCK was described as "Macro CK type 2." 14,15 However, the clinical significance of increased serum MtCK activity in cirrhotic patients has not been clarified yet.…”

“…8 In fact, an elevated serum MtCK activity was previously reported in patients with liver cirrhosis, 14 where MtCK was described as "Macro CK type 2." 14,15 However, the clinical significance of increased serum MtCK activity in cirrhotic patients has not been clarified yet. In our study, we wondered whether serum MtCK activity might be increased in patients with not only liver cirrhosis but also chronic liver disease, in general, with less fibrosis, and if so, what would be the clinical significance of increased serum MtCK activity in patients with chronic liver disease.…”