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Creatine Kinase Isoenzymes (CK-BB, CK-MM, CK-MB)


Definition


  • Creatine kinase is an enzyme consisting of three major isoenzymes, CK-BB (brain), CK-MB (heart), and CK-MM (skeletal muscle). CK-BB is rarely present. It has been described as a marker for adenocarcinoma of the prostate, breast, ovary, colon, and GI tract, and for small cell anaplastic carcinoma of the lung. CK-BB has been reported with severe shock and/or hypothermia, infarction of bowel, brain injury, stroke, as a genetic marker in some families with malignant pyrexia, and with MB in alcoholic myopathy. CK-MM is found in normal serum.

Use


  • Detection of macroforms of creatine kinase (CK)
    • Diagnosing skeletal muscle disease, in conjunction with aldolase
    • CK isoenzymes are not widely used in clinical practice today due to the use of troponin and CK-MB mass assays but may be useful in differential diagnosis when CK elevated as well
  • The CK-BB isozyme is rarely encountered clinically.

Interpretation


Increased In


  • Malignant hyperthermia, uremia, brain infarction or anoxia, Reyes syndrome, necrosis of the intestine, various metastatic neoplasms (especially prostate), biliary atresia
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