International Clinical and Medical Case Reports Journal (ISSN: 2832-5788) | Volume 2, Issue 9 | Case Report | Open Access
Ramya Badrachalam*
Department of Biochemistry, Sri ManakulaVinayagar Medical College & Hospital, Puducherry, India
*Correspondence to: Ramya Badrachalam
Fulltext PDFIntroduction: Creatine kinase (CK) catalyzes the conversion of creatine to phosphocreatine by utilizing Adenosine Triphosphate (ATP). This serves as reservoir of energy in tissues (muscles, heart and brain). So clinically CK is used as a marker of damage of CK-rich tissues.
Case Report: A blood sample of a 36 year old male patient with the history of trauma and complaints of fever associated with generalised edema & passage of dark urine for 1 week duration was received for routine investigations. Since the serum of the patient was clear irrespective of the dark urine. This gave us a suspicion of myolysis, so he was worked up for serum CK, serum Lactate Dehydrogenase (LDH), Aspartate Transaminase (AST) & Alanine Transaminase (ALT). His serum CK activity was alarmingly high. And the patient showed the evidence of hepatic damage with elevated liver markers started to rise from day 1 upon reaching its peak value on day 3 and returned back to normal on day 14. Microscopic examination of urine revealed the absence of Red Blood Corpuscles (RBCs). Benzidine test was strongly positive. He was on intravenous antibiotic therapy, steroids and hemodialysis during the hospital stay and the patient had a speedy recovery.
Conclusion: History of passage of dark cola coloured urine can be due to hemoglobinuria and myoglobinuria. Serum levels of CK always helps in the diagnosis of Rhabdomyolysis. Ammonium sulphate test will be the unique test to differentiate myoglobinuria from hemoglobinuria. A Simple ammonium sulphate test & serum CK values will help in the early diagnosis of Rhabdomyolysis and will improve the prognosis of the patient.
Creatine kinase (CK); Myoglobinuria; Rhabdomyolysis
Ramya Badrachalam, Asmathulla. S. A Curious Case of Abnormally Elevated Creatine Kinase Activity in Rhabdomyolysis.Int Clinc Med Case Rep Jour. 2023;2(9):1-2.