Elevated CPK

Question

I just got over PMR (stopped prednisone in Jan). I now have muscle aches through out my body. My CPK level is 234 and sedimetation rate is 26. I have angst about heart attacks. I can not find anywhere what 234 means. I know it is high, but how high does it go to? I also know that there are three different kinds of CPK and I am hoping mine is the third one. What is the treatment for elevated CPK?

Answer

CPK also called creatinine kinase (CK) is an enzyme (chemical) found specifically in muscle cells. One form of CPK is found in heart muscle cells, another in the skeletal muscle cells. CPK is also found in brain cells. When these cells are damaged for any reason, the CPK is released into the blood and can be measured by a blood test. If the heart CPK (CPK-MB) is elevated it can mean that the heart is damaged which can occur in a heart attack or in conditions in which the heart muscle is inflammed such as viral myocarditis. Skeletal muscle can be damaged in trauma such as in severe injury to the muscles, or after intense exercise causing an increase in the skeletal muscle form of CPK (CPK-MM). Certain drugs such as cholesterol lowering drugs (statins) can damage muscle and elevate CPK. Other causes are alcohol, viruses, hereditary conditions. Finally CPK can be elevated in certain autoimmune diseases that cause inflammation in the muscle such as polymyositis or dermatomyositis.

Your CPK is is only slightly elevated and many of the problems listed above have CPK elevations in the thousands. However, because you are having symptoms, you should be evaluated.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University