Elevation of myocardial creatine kinase in absence of myocardial injury (Case report with literature review)

Macro enzymes are high molecular mass complexes that consist of normal serum enzymes and protein-immunoglobulins. Creatine kinase (CK) is a muscle enzyme that has three isoenzymes. Two types of macro CK have been described; Macro CK type 1 and macro CK type 2. We report a case where cardiac enzymes were persistently elevated in the absence of myocardial injury. The false elevation was secondary to the presence of macro CK type 1 yielding aberrantly increased CK-MB. Our patient lacked clinical as well as electrocardiographic (EKG) changes to validate myocardial ischemia. Apperception of diagnosing falsely elevated cardiac markers is imperative to avoid unnecessary procedures   Key words: Macro CK, ischemia, myocardial infraction.