Rarely a macro form of creatine kinase (CK) may be encountered.
Presentation: elevation of serum CK not explained by usual causes. In some patients an elevation the cardiac isoenzyme (CK2) may raise concern of myocardial damage.
Source:
(1) enzyme-immunoglobulin complex
(2) ubiquitous type of mitochondrial CK (macro CK2)
The macro form has decreased clearance and a longer half-life than normal CK.
Conditions reported with macro CK:
(1) tenofovir treated patient with HIV
(2) colorectal cancer
With the advent of troponin testing the detection of the macro CK will probably decline.
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