There are some interesting inhereted enzyme defects that can result in elevated CPK. The most likely in this situation is carnitine palmitoyl transferase deficiency, in which CPK levels are normal or high normal into adulthood, but may become very elevated with physical activity. Additional work-up for you client is warranted and can be directed by his primary provider. It would be advisable for him to discontinue intense physical activity until the source of the problem is determined.
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