Causes of Elevated Creatine Phosphokinase

[Show Table Outline]

Pronounced Elevation (5 or more times normal)

• Early muscular dystrophy (CPK-MM, CPK₃)
• Acute myocardial infarction (CPK-MB, CPK₂)
• Severe angina (CPK-MB, CPK₂)
• Polymyositis (CPK-MM, CPK₃)
• Cardiac surgery

Moderate Elevation (2-4 times normal)

• Vigorous exercise
• Deep intramuscular injections
• Surgical procedures affecting skeletal muscles
• Delirium tremens
• Convulsive seizures
• Dermatomyositis
• Alcoholic myopathy
• Hypothyroidism
• Pulmonary infarction
• Acute agitated psychosis

Mild Elevation (up to 2 times normal)

• Late pregnancy
• Women heterozygous for the gene causing Duchenne's muscular dystrophy (CPK-MM, CPK₃)
• Brain injury (CPK-BB, CPK₁)

Adapted from Sacher, RA, and McPherson, RA: Widmann's Clinical Interpretation of Laboratory Tests, ed 11. FA Davis, Philadelphia, 2000, p. 536, with permission.

[Table Outline]

• Pronounced Elevation (5 or more times normal)
• Moderate Elevation (2-4 times normal)
• Mild Elevation (up to 2 times normal)