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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)

Creatinine Phospho Kinase (CPK) - Total