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Creatinine Phospho Kinase (CPK) - Total

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Creatine Phosphokinase (CPK) is an enzyme found in muscle tissue and the brain. There are three isoenzymes: CK-MM/Skeletal Muscle; CK-MB/Heart Muscle and CK-BB/Brain tissue

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🧪 Creatine Phosphokinase (CPK / CK) – Total

Test Name

CPK (Creatine Phosphokinase) – Total

Also Known As

Creatine Kinase (CK) Total, Total CPK

Sample Type

Serum (blood)

Fasting Required

❌ Not required (but avoid intense activity before test)

Normal Range

~ 22–198 U/L (may vary by age, gender, lab method)

Turnaround Time

1 day (urgent if needed)

Primary Use

Evaluate muscle injury, including heart, brain, and skeletal muscle

🧬 What is CPK?

Creatine Phosphokinase (CPK) is an enzyme found in muscle tissue and the brain. It plays a key role in energy metabolism, especially in tissues with high energy demands.

There are three isoenzymes:

Isoenzyme

Found In

Associated With

CK-MM

Skeletal muscle

Muscle injury, strenuous exercise

CK-MB

Heart muscle

Myocardial infarction (heart attack)

CK-BB

Brain tissue, smooth muscle

Brain trauma, CNS disorders

🔍 Why is the CPK Total Test Done?

Purpose

Use Case

Detect muscle damage

Due to trauma, exercise, seizures, injections, rhabdomyolysis

Support diagnosis of heart attack

CK-MB fraction is more specific; Total CPK may rise in early phases

Diagnose neuromuscular diseases

Like Duchenne muscular dystrophy, myositis

Evaluate seizures or stroke

CK-BB may rise in brain injury

Monitor statin-induced myopathy

In patients on cholesterol-lowering drugs

📈 CPK Level Interpretation

CPK Level

Possible Interpretation

🔻 Low/Normal

No significant muscle damage

🔺 Mildly Elevated

Exercise, injections, or minor muscle strain

🔺🔺 Moderately High

Myositis, trauma, statin-related myopathy

🔺🔺🔺 Very High

Rhabdomyolysis, severe muscular dystrophy, massive trauma, seizures

💡 Levels > 5,000–10,000 U/L often indicate rhabdomyolysis, a medical emergency.

⚠️ Conditions That May Affect CPK Levels

Elevated CPK May Occur In

Explanation

Heavy exercise

Especially untrained muscles

Injections/intramuscular medications

Temporary spike in CK-MM

Seizures or stroke

Brain involvement (CK-BB)

Heart attack

CK-MB rises within total CK

Muscle diseases

Dystrophies, polymyositis, etc.

Medications (e.g., statins, antipsychotics)

Drug-induced myopathy

🧪 Other Tests Often Ordered With Total CPK

Test

Purpose

CK-MB

Cardiac-specific isoenzyme

Troponin I or T

Most specific for myocardial infarction

LDH (Lactate Dehydrogenase)

For broader tissue injury evaluation

Aldolase

Supports diagnosis of muscle disorders

Electrolytes (especially K+, Ca2+)

Monitor for imbalances from muscle breakdown

Renal Function Tests

To check for kidney damage in rhabdomyolysis

🧠 Summary Table

Marker

Total CPK / CK

Organ/System

Muscle (skeletal, heart, brain)

Used For

Detecting general muscle damage, early cardiac injury

Best Paired With

CK-MB, Troponin, LDH, renal tests, electrolytes

Interpreted With

Clinical symptoms (pain, weakness, trauma, seizure)

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