Ghosh Abhra, Datta Priyanka, Dhingra Manthan
Biochemistry, Dayanand Medical College and Hospital, Ludhiana, IND.
Biochemistry, Nil Ratan Sircar (NRS) Medical College and Hospital, Kolkata, IND.
Cureus. 2023 Dec 19;15(12):e50792. doi: 10.7759/cureus.50792. eCollection 2023 Dec.
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.
肌酸激酶（CK）酶及其同工酶具有重要的诊断价值，在不同组织中呈现出不同的模式。估算肌酸激酶MB（CK-MB）的最常用方法是基于免疫抑制。然而，该方法在各种情况下可能会报告CK-MB水平假性升高。CK-MB水平持续升高或测量值与患者临床状况之间存在差异时，需要进一步检查，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死并按照既定指南进行治疗的病例。然而，除了心脏症状缓解后CK-MB持续升高以及CK-MB与总CK比值较高外，患者还出现腹痛，提示存在其他病变。通过全面的实验室检查，包括定量CK同工酶电泳和腹部增强计算机断层扫描（CECT），随后进行急诊手术干预，最终确诊为急性小肠梗死。
