--- In dysferlin@y..., "natalisan" <natalisan@y...> wrote:
> Hi, everyone,
> My name is Phalevi. I'm a french medical student interested in
> distal myopathies and of course dysferlinopathies. (so be lenient
> with the english language :-))
> In fact, I'm a general practitionner, not an expert in neurology
nor
> muscle disorders but I'm willing to learn from all of you.
> One of my great inspiration is the creator of this site-group who
> is "THE" dysferlinopathies real expert, Brad ( Salut Brad, pardon
de
> t'envahir mais cela me démangeait de réagir sur les CPK :))
> As a clinician, my experience about CPK is more general. I just
> wanted to add some remarks I noticed in my daily practise to
> illustrate the non specifity of that test to a muscular dystrophy.
>
> CK means Creatin Kinase aka Creatin PhosphoKinase CPK (term used
in
> France). It's an intracellular enzym which is present for most of
the
> part in the muscle, skeleton muscle ( fraction called CPK MM),
heart
> muscle (fraction called CPK MB) but also in brain tissue (fraction
> called CPK BB).
> The function of this enzym is to release the energy necessary for
the
> muscle to contract, from a chemical reaction with an energy storage
> protein in the muscle, the creatin phosphate. .
> If, for any reasons, the muscle cells are damaged, as Brad said,
the
> enzym will leak into bloodstream.
> The blood test reflects the 3 fractions and could be considered as
a
> marker of a muscle suffering.
> The CPK increase is the "calling sign" of a muscle damaging
> process, which should lead to more precise investigations, specific
> to a disease.
>
> Even in sane people, CPK is released in blood because in normal
> muscle tisssue, some cells will end their life and others will
begin.
> The normal rate depends on the different methods used by
> laboratories. If you pay attention to your blood tests, they
usually
> give you the normal values as reference.
> For information I can give the normal rate N of CPK
> in "international unit = UI Unité Internationale" we use in my
> country.
> Male N: 0 - 195 UI /l
> Female N: 0 - 170 UI /l
>
> The interpretation of a pathologic CPK rate is
> 1-always compared to the normal rate, 2N, 5N, >10N etc...because we
> know that such or such muscle pathology tend to have xN
> 2-always confronted to the clinical signs and the other
complementary
> exams. (other muscle enzyms, scan, RMI, EMG, muscle biopsy...)
>
> High rate of CPK has numerous causes and the main indications of
this
> blood test in practise are:
> 1- a pain chest because a raise of the CPK MB fraction is suspect
of
> a heart stroke.
> 2- all muscle symptoms, pain, fatigue, atrophy, hypertrophy,
> stiffness, soreness, cramp....leading to explore myopathies,
> inflammatory or viral myositis, neuromuscular dystrophy...
> 3- traumatisms with bruises, during accident, or during a violent
> physical effort.
> 4- the use of anticholesterol drugs, some antibiotics or
vaccines
> which could give muscle suffering.
> 5- sometimes, in meningitis (CPK BB), cerebral vascular stroke,
some
> cancers, hypothyroidism.
>
> From my POV, this test is an instant reflect of a muscle suffering
> state. It can't be related to a specific muscular disease
> but it could help or guide to a diagnosis. Considering it as a
> pronostic, or a severity factor, is more than debatable. In the
other
> hand, when new treatements are experimented it could be an
> interesting marker of efficiency and surveillance.