Creatine Kinase - Causes of Elevated CK Levels
Acute CK Elevation (Pain > Weakness):
 • RHABDOMYOLYSIS
    - Drugs: cocaine, amphetamines, alcohol
     - Medications: statins, fibrates, colchicine, daptomycin
     - Illness: viral (COVID19, CMV/EBV, HIV), clostridial spp, mycoplasma, staph, strep)
     - Seizures: Trauma, burns, hyperthermia, immobility
 • Critical Illness Myopathy (ICU, steroids, mechanical ventilation)
 • Myocardial infarction, Acute renal injury, Strenuous exercise
Subacute to Chronic Causes (Weakness > Pain):
 • PROXIMAL MUSCLE WEAKNESS
    - Endocrine: Hypo/hyperthyroidism, acromegaly
    - Electrolytes: hypo- phos, kalemia, calcemia, natremia
    - Muscular dystrophy
    - Metabolic Myopathies
    - Neuromuscular disorders
    - Vit D/E deficiency
    - Medications- Statins, fibrates, colchicine, daptomycin
    - Chronic Illness: HIV, Trichinella, toxoplasmosis
    - Inflammatory myopathy: dermatomyositis, polymyositis, necrotizing myopathy
    - Autoimmune: mixed connective tissue disorder, SLE
 • PROXIMAL AND DISTA: Inclusion body myositis
 • ASYMPTOMATIC: Macro CK

Ann Marie Kumfer @AnnKumfer

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