Orvosi hetilap · 2003
[Macro-creatine kinase: an interesting occurrence that can cause diagnostic mistake].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Kovács Ferenc, Dobos András
Аннотация
INTRODUCTION: Macroenzymes have been known for a long time. Macro-creatine kinase is important among them, because it can cause serious diagnostic misunderstanding.
OBJECTIVE: The authors describe a case in which creatine kinase MB isoenzyme activity measured by immunoinhibition was much higher than total creatine kinase activity.
METHOD: The presence and type of possible macro-creatine kinase was examined by the authors with heat-stability test and electrophoresis.
RESULTS: Total creatine kinase and creatine kinase MB isoenzyme activity measured by immunoinhibition of macro-creatine kinase sample remained still unchanged, while activity of control samples decreased significantly. Macro-creatine kinase remained on the carrying point, while isoenzymes migrated accordingly in the other samples during electrophoresis.
CONCLUSION: Two types of macro-creatine kinase are known. In the first the BB isoenzyme of enzyme joint to immunoglobulin (mostly immunoglobulin G) and its presence may refer to autoimmune factors. The second type is a polymer of mitochondrial creatine kinase and appears in malignant tumours mainly. The presented case the clinic of the patient, the heat-stability test and the typical electrophoretic migration proved the presence of the second type.
OBJECTIVE: The authors describe a case in which creatine kinase MB isoenzyme activity measured by immunoinhibition was much higher than total creatine kinase activity.
METHOD: The presence and type of possible macro-creatine kinase was examined by the authors with heat-stability test and electrophoresis.
RESULTS: Total creatine kinase and creatine kinase MB isoenzyme activity measured by immunoinhibition of macro-creatine kinase sample remained still unchanged, while activity of control samples decreased significantly. Macro-creatine kinase remained on the carrying point, while isoenzymes migrated accordingly in the other samples during electrophoresis.
CONCLUSION: Two types of macro-creatine kinase are known. In the first the BB isoenzyme of enzyme joint to immunoglobulin (mostly immunoglobulin G) and its presence may refer to autoimmune factors. The second type is a polymer of mitochondrial creatine kinase and appears in malignant tumours mainly. The presented case the clinic of the patient, the heat-stability test and the typical electrophoretic migration proved the presence of the second type.