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Elevated creatine kinase suggests better prognosis in patients with amyotrophic lateral sclerosis.
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J Neurol Neurosurg Psychiatry 2013 Nov; 84(11):e2
Authors: Muhammad Rafiq, Ellen Lee, Michael Bradburn, Christopher McDermott, Pamela Shaw
University of Sheffield.
Creatine kinase (CK) is an enzyme found in skeletal muscles, myocardium and brain (CK-MM, CK-MB, and CK-BB isoenzymes respectively). In these tissues with high energy requirements, CK catalyses conversion of phosphocreatine to creatine, generating adenosine triphosphate. Elevated CK-MM is considered a marker of muscle damage. In the past, CK has been used to differentiate between myopathic and neurogenic disease, higher CK being associated with myopathic disease. It is now recognised that CK may be mildly to moderately elevated in patients with amyotrophic lateral sclerosis (ALS). An obvious explanation of raised CK in ALS is striate muscle atrophy resulting from degeneration of the subserving motor neurons. Another possible explanation is upregulation of this enzyme to provide an energy substrate in a hypercatabolic condition. The reason that CK elevation occurs in only a proportion of ALS cases, the precise cause and its behaviour with disease progression is unknown.
PMID: 24109000 [PubMed - as supplied by publisher]