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A Case of Creatine Kinase Non-M Activity in Human Plasma

The enzyme creatine kinase (CK) [EC 2.7.3.2] is a dimeric molecule consisting of two separate subunits Band M, giving rise to three isoenzymes CK-BB, CK-MB and CK-MM. Most of the CK found in the plasma of normal individuals is the MM isoenzyme derived from skeletal muscle, while the CK-MB fraction originates predominately from cardiac muscle. Normally there is little, if any, CK-BB isoenzyme present in plasma. Other forms of. CK can exist in the plasma in certain individuals and these include macro-forms, which include CKBB bound to IgG (CK type 1) and also a mitochondrial isoenzyme (CK type 2). In this article we describe a patient who presented with an abnormal plasma total CK activity and illustrate potential problems in the interpretation of plasma CK results, with particular emphasis upon possible causes of elevated plasma non CK-M activity.