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Dermatomyositis is a muscle disease characterized by inflammation and a skin rash. It is a type of inflammatory myopathy.
Causes, incidence, and risk factorsThe cause of dermatomyositis is unknown. Experts think it may be due to a viral infection of the muscles or a problem with the body's immune system. It can also sometimes occur in patients who have cancer of the abdomen, lung or other body area.
Anyone can develop dermatomyositis, but it most commonly occurs in children age 5 - 15 and adults age 40 - 60. Women develop this condition more often than men do.
Polymyositis is a similar condition, but the symptoms occur without a skin rash.
Symptoms- Difficulty swallowing
- Muscle weakness, stiffness, or soreness
- Purple or violet colored upper eyelids
- Purple-red skin rash
- Shortness of breath
The muscle weakness may appear suddenly or develop slowly over weeks or months. You may have difficulty raising your arms over your head, rising from a sitting position, and climbing stairs.
The rash may appear over the face, knuckles, neck, shoulders, upper chest, and back.
Signs and testsThe doctor will perform a physical exam. Tests may include:
- Bloods test to check levels of creatine phosphokinase and aldolase
- ECG
- Electromyography
- Magnetic resonance imaging (MRI)
- Muscle biopsy
The disease is treated with anti-inflammatory medicines called corticosteroids and drugs that suppress the immune system.
When your muscle strength gets better, your doctor may tell you to slowly cut back on your doses. However, most people with this condition must take a medicine called prednisone indefinitely.
If the condition is associated with a tumor, the muscle weakness and rash may improve when the tumor is removed.
Expectations (prognosis)Some people may recover and have symptoms completely disappear. Doctors have reported several such cases, especially in children.
In adults, death may result from severe and prolonged muscle weakness, malnutrition, pneumonia, or lung failure. The major causes of death are cancer (malignancy) and lung disease.
Complications- Acute renal failure
- Cancer (malignancy)
- Inflammation of the heart
- Joint pain
- Lung disease
Call for an appointment with your health care provider if you have muscle weakness or other symptoms of this condition.
ReferencesGoldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007.
Reviewed ByReview Date: 02/08/2011
Richard J. Moskowitz, MD, Dermatologist in Private Practice, Mineola, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Dermatomyositis is identical to polymyositis with the addition of a characteristic skin rash.
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The first cases of dermatomyositis were discovered by E. Wagner in 1863 and P. Potain in 1875.
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In dermatomyositis, the muscle weakness is accompanied by a rash that appears on the upper body, arms, and fingertips
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Dermatomyositis (DM) and inclusion body myositis and juvenile dermatomyositis.
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Dermatomyositis was first described by Thomas Adolph Schweninger, a German doctor, in 1860. He observed the characteristic skin and muscle changes in patients with this condition.
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Dermatomyositis can be a serious condition but is not typically fatal on its own. However, complications related to the disease or its treatments may increase the risk of mortality. Close monitoring and appropriate management by healthcare providers are essential for individuals with dermatomyositis to help improve outcomes and quality of life.
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Yes, dermatomyositis can affect swallowing because it can cause muscle weakness and inflammation in the muscles of the throat and esophagus. This can lead to difficulty with swallowing, a condition known as dysphagia. It is important for individuals with dermatomyositis experiencing swallowing difficulties to seek assessment and treatment from healthcare providers.
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Dermatomyositis
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Dermatomyositis is often first apparent as a rash. The rash, which can be bluish-purple in color, reminiscent of bruising, typically occurs in patches on the face, neck, shoulders, upper portion of the chest, elbows, knuckles, knees, and back.
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Individuals are given steroid drugs (prednisone, corticosteroids ) that suppress the immune system
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In about 5% of individuals the disease progresses to death because of heart and lung involvement
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The IMs include dermatomyositis, polymyositis, and inclusion body myositis.
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An increased level of creatine kinase in the blood suggests DM as a possible diagnosis
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Dermatomyositis(DM) is a connective-tissue disease related to polymyositis(PM) that is characterized by inflammation of the muscles and the skin.
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In all age groups, females are twice as likely to develop the disease than males
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Muscular Dystrophy, Cerebral Palsy,
Fibrodysplasia Ossificans Progressiva, Dermatomyositis,
Compartment Syndrome,
Myasthenia Gravis, Amyotrophic Lateral Sclerosis, Mitochondrial Myopathies,
Rhabdomyolysis,Polymyositis,Fibromyalgia,Myotonia,Myofascial Pain Syndrome and etc.
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Serious complications from DM include involvement of the muscles of the heart and lungs, difficulty eating and swallowing, and a tendency to develop cancer
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In about 20% of people, the disease spontaneously goes into remission and individuals are able to lead symptom-free lives for long periods
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Most often individuals either develop DM either between the ages of five and 14 or they do not develop it until they are over age 45
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Often the first sign of DM is the development of a patchy, scaly, violet to dark red skin rash on the face, neck, shoulders, upper chest, knees, or back
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Dermatomyositis is an autoimmune disease that affects skin and muscle.
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The causes of IM are not known. An autoimmune process is likely, as these conditions are often associated with other autoimmune diseases and because they respond to immunosuppressive medication.
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Juvenile dermatomyositis is a rare autoimmune disease that primarily affects children. It is characterized by inflammation of the muscles and skin, leading to muscle weakness, skin rash, and other systemic symptoms. Treatment typically involves a combination of medications, physical therapy, and other supportive measures to manage symptoms and improve quality of life.
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The cause of dermatomyositis is a disruption in the functioning of the immune system, although the precise details of the malfunction are not yet known. While the basis of the disease may be due to a genetic mutation, conclusive evidence is lacking.
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I have read that 8-10 mg of biotin daily works. I lost hair from dermatomyositis and my hair started growing after about 4-6 weeks of taking biotin. I believe it works!
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The cause is largly unknown, however some science suggests that it can be cause by bacterial infections, or viruses. The focus is primarily on treatment of the symptoms and not the cause thereof.
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The most common symptoms are muscle weakness and a rash that appears to be purple or bue-purple that forms around the eyes or fingernails. Other symptoms can include muscular pain, difficulty swallowing, gastric ulcers, fever or weight loss.
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Myositis is a general term for inflammation of the muscles. There can be several causes. The most common being polymyositis and dermatomyositis.
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Myositis is an inflammation or swelling of the muscles, often caused by injury, infection, or an autoimmune disorder.
See also:
Alternative NamesMyitis
ReferencesMiller FW. Polymyositis and dermatomyositis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 290.
Reviewed ByReview Date: 05/24/2011
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as asthma,uveitis, pyoderma gangrenosum, rheumatoid arthritis, ulcerative colitis, temporal arteritis and Crohn's disease, Bell's palsy, multiple sclerosis,[4]cluster headaches, vasculitis, acute lymphoblastic leukemia and autoimmune hepatitis,[5]systemic lupus erythematosus, and dermatomyositis
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The term Juvenile arthritis may refer to a number of different types of arthritis that occur in children and teenagers the most prevalent type is "juvenile idiopathic arthritis" (JIA), This disease is also known as juvenile rheumatoid arthritis (JRA) or juvenile chronic arthritis (JCA).
Types of juvenile arthritis include
juvenile idiopathic arthritis (or juvenile rhuematoid arthritis), including oligoarthritis, polyarticular and systemic
spondyloarthropathies, including ankylosing spondylitis, psoriatic arthritis and reactive arthritis
fibromyalgia
and other types, such as Perthes disease, lupus, dermatomyositis and scleroderma
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No. Spasms are not generally considered a symptom of polymyositis (PM).
But having spasms does not mean you do not have polymyositis. You might, and the spasms from something else, like over exertion, dehydration, or lack of carbohydrates, etc. -- and then also have PM.
So, you should see your physician first.
Don't let your physician brush you off (like I let my first doctor do).
A good idea is to write down your symptoms. He'll still interview you, because that is part of his routine. But he might see something he didn't think to ask in what you wrote down.
If you feel muscle weakness, describe the pattern of muscle weakness. What activities and motions you are having difficulty with? Is there pain? Is there no pain? Details like that can be important clues.
Once you have a tentative diagnosis from your physician, then you can learn more about your condition on the web.
If you've been to your doctor, and he or she is coming up blank, then try a second doctor, then try the web.
If you try to self-diagnose, what you read might affect the symptoms you perceive. Your physician might discount what you say because of a feeling that what you've read is influencing what you perceive. I didn't google my symptoms until after my doctor gave me a tentative diagnosis.
PM and DM (dermatomyositis) are very rare diseases. The incidence of both combined is somewhere between 1 in 10,000 and 1 in 100,000. Hopefully you have something else.
I'm a dermatomyositis patient. DM is a very similar disease to PM, the muscle symptoms are the same, but with DM you also get rashes. So I've read quite a bit about both. (However, the internal mechanism of PM and DM are different.) I have a cousin with PM.
I'm not a medical professional.
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CPK is an enzyme that stands for Creatine Phospho Kinase. It is elevated in :
- Myocardial infarction (MI),
- Myocarditis,
- Traumatic Muscle injury,
- Rhabdomyolysis,
- Muscular dystrophy,
- Myositis, polymyositis, Dermatomyositis, Myopathy,
- Severe muscular exertion,
- Malignant hyperthermia,
- Hypothyroidism,
- Cerebral infarction,
- Surgery,
- Reye syndrome,
- Tetanus,
- Convulsions,
- IM injections,
- Alcoholism,
- DC Shock.
- Drugs: clofibrate, HMG-CoA reductase inhibitors like Simvastatin
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High levels of rheumatoid factor (in general, above 20 IU/mL, 1:40, or over the 95th percentile; there is some variation among labs) occur in rheumatoid arthritis (present in 80%) and Sjögren's syndrome (present in 70%). The higher the level of RF the greater the probability of destructive articular disease.[citation needed] It is also found in Epstein-Barr virus or Parvovirus infection and in 5-10% of healthy persons, especially the elderly.
There is an association between rheumatoid factor and more persistently active synovitis, more joint damage and greater eventual disability.
Rheumatoid factor may also be elevated in: chronic hepatitis, primary biliary cirrhosis, any chronic viral infection, bacterial endocarditis, leukemia, dermatomyositis, infectious mononucleosis, systemic sclerosis, and systemic lupus erythematosus (SLE).
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The prognosis for this disorder varies according to its specific type and how it has progresses. While some cases of this disorder are mild and progress slowly, other cases can be more severe and have a rapid progression. Some people can live many years with this disease, while others with the severe form can die in infancy or during childhood. This disorder is a genetic disease that in some people manifests in childhood. However, this disorder also can affect a person later in life.
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Heliotrope cyanosis is a bluish-purple discoloration of the skin around the eyes, typically seen in patients with dermatomyositis, an autoimmune inflammatory myopathy. It is often accompanied by muscle weakness and a characteristic rash. Prompt medical evaluation and treatment are essential to manage this condition effectively.
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That would not be terribly high for a woman of 75. However the level of the RA does not necessarily relate to the seriousness of the RA you may have. normal RF in a young woman is up to 20 this rises with age and after menopause.
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Lupus, Lyme Disease, Adult Onset Still's Disease, Marfan Syndrome, Ankylosing Spondylitis, Mycotic Arthritis, Osgood-Schlatter Disease, Osteitis Deformans, Aseptic Necrosis, Osteoarthritis, Avascular Necrosis, Osteonecrosis, Basal Joint Arthritis, Osteoporosis, Behcet's Disease, Bursitis, Paget's Disease of Bone, Carpal Tunnel Syndrome, Palindromic Rheumatism, Celiac Disease, Polyarteritis Nodosa, CMC Arthritis, Polymyalgia Rheumatica, Complex Regional Pain, Polymyositis, Costochondritis, Pseudogout, Psoriatic Arthritis, Crohn's Disease, Raynaud's phenomenon, Degenerative Joint Disease, Dermatomyositis, Reiter's Syndrome, Discoid Lupus, Erythematosus, Ehlers-Danlos Syndrome, Rheumatic Fever, Eosinophilic Fasciitis, Rheumatoid Arthritis, Felty Syndrome, Scleroderma, Fibro myalgia, Septic Arthritis, Fifth Disease, Sjogren's Syndrome, Forestier Disease, Somatotroph Adenoma, Fungal Arthritis, Spinal Stenosis, Gaucher Disease, Takayasu Arteritis, Giant Cell Arteritis, Temporal Arteritis Gonococcal Arthritis, Tendonitis, Gout, Tietze's Syndrome, Henoch-Schonlein Purpura, TMJ / TMD, Infectious Arthritis, Tuberculous Arthritis. Inflammatory Bowel Disease, Ulcerative Colitis, Joint Hyper mobility, Vasculitis, Juvenile Arthritis, Viral Arthritis, Kawasaki Disease, Wegener's Granulomatosis, Legg-Calve-Perthes Disease,
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- In general, the outlook is good. Lichen planus of the skin usually goes without leaving any ongoing problems.
- Without treatment, about half of cases of lichen planus affecting the skin clear within 6-9 months. The rest usually clear soon after this. It is unusual for the rash to last longer than 18 months. However, lichen planus persists longer in a small number of people who are severely affected. This is mostly in people who develop lichen planus mouth ulcers, and lichen planus of the vulva or penis.
- Treatment can usually ease skin symptoms until the rash clears.
- For lichen planus of the skin, once the rash has cleared, about 1 in 5 affected people have a recurrence sometime in the future. A small number of people have several recurrences.
- If lichen planus affects nails or hair, any damage such as bald patches or destroyed nails is permanent.
- People with lichen planus have a slightly higher than average chance of developing other 'inflammatory' diseases. For example: ulcerative colitis, alopecia areata, vitiligo, dermatomyositis, morphea, lichen sclerosis, and myasthenia gravis. This is probably due to some people being more prone to 'immune' or 'inflammatory' conditions. However, most people with lichen planus do not develop any of these other conditions.
- If painful ulcers develop in the mouth due to lichen planus, then there is higher than average chance of developing cancer of the mouth. Again, most people do not but regular mouth checks from a dentist are advisable.
- If the vulva is badly affected, there is a slight increased risk of developing cancer of the vulva.
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For the nurse who likes to have a direct and immediate role in patient health care and a range of venues in which to work, intravenous therapy is a field filled with many opportunities.
Intravenous, more commonly known as IV, therapy is the administration of medications through a needle into a patient’s body that usually lasts for a number of hours. Patients commonly in need of IV therapy have chronic neurologic conditions, such as multiple sclerosis and dermatomyositis, or autoimmune diseases such as psoriatic arthritis and Guillain-Barre syndrome, for example. The IV therapy, in these cases, can be used in situations where symptoms become acute (get worse), or as part of ongoing therapy.
IV therapy can also be used in chemotherapy and other uses; in fact, more reasons are found for IV therapy all the time. It can be administered in physician’s offices and clinics, as an inpatient or outpatient at a hospital, or in the patient’s home.
The nurse who administers IV therapy is usually responsible for carrying out doctor’s orders, obtaining the various IV medications needed, inserting the IV needle and calibrating and maintaining the machine the IV lines pass through that regulates the speed and duration of the medication entering the body. The IV nurse makes regular checks on the patient, taking vital signs and seeing to their comfort.
Every state can have different criteria and rules about who can insert IV lines, but generally one needs to be at least an LVN or LPN (licensed vocational, or licensed practical nurse). As to the administration of the medication and patient care needed, an RN (registered nurse) might be required.
The national median hourly wage for an LPN ranges from approximately $15.03 to $20.18 an hour. The national median hourly wage for an RN ranges from approximately $22.07 to $30.76 an hour. Depending on the years of experience and the demands of the particular job the nurse holds, salaries and compensation can vary.
One of the advantages regarding the nursing field is the great variety and flexibility of jobs offered. An IV nurse is only one of hundreds of different jobs available for those who hold any variety of nursing degrees.
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Two common types of arthritis are Osteoarthritis (OA) and Rheumatoid Arthritis (RA). Osteoarthritis is a degenerative condition caused by wear and tear on the joints, leading to pain and stiffness. Rheumatoid Arthritis, on the other hand, is an autoimmune disorder where the body's immune system attacks the joints, causing inflammation and pain. Supporting joint health with a supplement like JointXL Plus can help manage inflammation and improve joint function, making it a valuable addition to your arthritis care routine.
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The normal range for rheumatoid factor is less than 20 (this is dependent on the laboratory). The following disordersAdjustment disorder
Anorexia nervosa
Asperger syndrome
Autism
Autoimmune disorders
Bipolar disorder
Bleeding disorders
Borderline personality disorder
Copd (chronic obstructive pulmonary disorder)
Chronic motor tic disorder
Conversion disorder
are associated with an elevated rheumatoid factor:
Rheumatoid arthritis 26 to 90 percent
Sjgren's syndrome 75 to 95 percent
Mixed connective tissue disease 50 to 60 percent
Mixed cryoglobulinemiaCryoglobulinemia - of the fingers
(types II and III) 40 to 100 percent
SystemicSystemic lupus erythematosus
Systemic lupus erythematosus rash on the face
lupus erythematosus 15 to 35 percent
Polymyositis/dermatomyositis five to 10 percent
This test is not traditionally used for screening purposes as it has a low yield in healthy populations. With this elevated level, further testing is necessary to confirm a diagnosis. An elevated rheumatoid factor by itself is not enough for a diagnosis.
A rheumatoid factor blood test measures the amount of the RF antibody in the blood.
Rheumatoid Factor test may be reported in either "titers" or "units":
" A titer" is a measurement of how far a sample of blood can be diluted before RF can no longer be detected. A titer of "1:20" means that RF can be detected when 1 part of the blood sample is diluted by up to 20 parts of saline. the larger the second number in the titre the larger the RF factor.
"Nephelometry" units indicate the amount light that is blocked by the blood sample. Samples with a high level of RF are cloudier then normal, and as a result less light passes through the tube than when the RF level is low. therefore in the case of the RF test the higher number indicates the higher RF. for example. an RF level of 90 units is higher than one of 40 units.
Normal values depend on what lab is doing the tests. Results are usually available within 2 days.
Rheumatoid factor (RF) Titers 1:20 to 1:80
NephelometryUnits 14 units/mL to 60 units/mL
You should find out from your doctor to see what are normal ranges for the lab that tested your blood.
High RF often acompany
Rheumatoid arthritis. 80% of those aflicted with RA have a positive (RF) level.
Hepatitis C infection.
Other autoimmune diseases, such as systemic lupus erythematosus (SLE), scleroderma, Sjögren's syndrome, and vasculitis.
Infectious diseases, including tuberculosis, mononucleosis, syphilis, and malaria.
Liver diseases, such as cirrhosis and chronic active hepatitis.
Infection of the heart (endocarditis).
Leukemia.
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Necrotizing vasculitis is a rare condition that involves inflammation of the blood vessel walls.
Alternative NamesVasculitis - necrotizing
Causes, incidence, and risk factorsNecrotizing vasculitis is common with:
- Polyarteritis nodosa
- Rheumatoid arthritis
- Scleroderma
- Systemic lupus erythematosus
- Wegener's granulomatosis
It is very rare in children.
The cause of the inflammation is unknown. It is likely related to autoimmunefactors. The wall of the blood vessel may scar and thicken, or die (become necrotic). The blood vessel may close, interrupting blood flow to the tissues it supplies. The lack of blood flow will cause the tissues to die.
Necrotizing vasculitis may affect any blood vessel in the body. Therefore, it can cause problems with the skin or any of the body's organs.
SymptomsFever, chills, fatigue, or weight loss may be the only symptoms at first. However, symptoms may be in almost any part of the body.
Skin:
- Abnormal skin tissue (lesions)
- Papules (small, solid, and raised lesions)
- Red or purple colored
- Located on the legs, hands, or other parts of the body
- Fingers that change color (blue fingers or toes)
- Tissue death due to lack of oxygen
- Pain or tenderness in the area
- Skin redness
- Sores (ulcers) that do not heal
Muscles and joints:
- Joint pain
- Leg pain
- Muscle contractions
- Wasting away of muscles
Brain and nervous system:
- Pain, numbness, tingling in an arm, leg, or other body area
- Weakness of an arm, leg, or other body area
- Pupils that are different sizes
- Eyelid drooping
- Swallowing difficulty
- Speech impairment
- Movement difficulty
Other symptoms include:
- Abdominal pain
- Blood in the urine or stools
- Painful menstruation
- Hoarseness or changing voice
- Symptoms related to damage of the arteries that supply the heart (coronary arteries)
The doctor will perform a physical exam. A nervous system (neurological) examination may show signs of nerve damage.
Tests that may be done include:
- Biopsy of the muscle, organ, tissue, or nerve biopsy
- Chest x-ray
- Sedimentation rate
- Urinalysis
- Hepatitis blood test
- Blood test for antibodies against neutrophils (ANCA antibodies)
Corticosteroids (given in low doses) or other drugs that suppress the immune system may reduce inflammation of the blood vessels.
See also:
Expectations (prognosis)The outcome depends on the location of the vasculitis and the severity of tissue damage.
Complications- Permanent damage to the structure or function of the affected area
- Secondary infections of necrotic tissues
Call your health care provider if you have symptoms of necrotizing vasculitis.
Emergency symptoms include:
- Changes in pupil size
- Loss of function of an arm, leg, or other body part
- Speech problems
- Swallowing difficulty
- Weakness
There is no known way to prevent this disorder.
ReferencesCassidy JT. Systemic lupus erythematosus, juvenile dermatomyositis, scleroderma, and vasculitis. In: Firestein GS, Budd RC, Harris Jr. ED, McInnes IB, Ruddy S,eds. Kelley's Textbook of Rheumatology. 8th. Philadelphia, Pa: W. B. Saunders Company; 2008: chap 98.
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Polymyositis is a relatively uncommon inflammatory disease that leads to significant muscle weakness.
Causes, incidence, and risk factorsPolymyositis is a skeletal muscle disease also known as idiopathic inflammatory myopathy. The cause of this disorder is unknown. It is thought that an autoimmune reaction or a viral infection of the skeletal muscle may cause the disease.
It can affect people at any age, but most commonly occurs in those between 50 and 70 years old, or in children between 5 and 15 years old. It affects women twice as often as men. It is more common in African-Americans than Caucasians. Overall, about 1 in 100,000 people are diagnosed with some form of inflammatory myopathy each year.
Muscle weaknessmay appear suddenly or occur slowly over weeks or months. The weakness is due to inflammation and the breakdown of the muscles. Patients with this disease may have difficulty raising their arms over the head, rising from a sitting position, or climbing stairs. The voice may be affected through weakness of the throat muscles.
A similar condition, called dermatomyositis, is marked by a dusky, red rash that appears over the face, knuckles, neck, shoulders, upper chest, and back.
SymptomsPolymyositis is a systemic disease, which means it affects the whole body. Symptoms include:
- Difficulty swallowing
- Muscle pain
- Muscle weakness in the proximal muscles (shoulders, hips, etc.)
- Shortness of breath
Patients may also have morning stiffness, joint pain, fatigue, anorexia, weight loss, and fever.
Signs and tests- CPK, elevated
- Electromyography
- MRI of affected muscles
- Muscle biopsy
- Serum aldolase, elevated
The disease is treated with corticosteroid medications. When an improvement in muscle strength is achieved, usually in 4 to 6 weeks, the medication is slowly tapered off. Maintenance therapy with prednisone may be continued indefinitely. In people who fail to respond to corticosteroids, medications to suppress the immune system may be used.
If the condition is associated with a tumor, the condition may improve if the tumor is removed.
Expectations (prognosis)Remission (a period when no symptoms are present) and recovery occur in many patients, especially children. For most others, immunosuppressant drugs can control the disease. In adults, death may result from severe and prolonged muscle weakness, malnutrition, pneumonia, or respiratory failure. The major causes of death are cancer (malignancy) and lung disease.
Complications- Associated cancer (malignancy)
- Calcium deposits in the affected muscles, especially in children with the disease
- Heart disease, lung disease, or abdominal complications
Call your health care provider if you have symptoms of this disorder. Seek emergency treatment if you have shortness of breath and difficulty swallowing.
ReferencesHarris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005:1312-1316.
Goldman L, Ausiello D. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders; 2007.
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Creatine phosphokinase (CPK) is an enzyme found mainly in the heart, brain, and skeletal muscle. This article discusses the test to measure the amount of CPK in the blood.
See also: CPK isoenzymes
Alternative NamesCPK test; Creatine kinase
How the test is performedBlood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
The blood sample is sent to a lab, where the amount of CPK is measured.
This test may be repeated over 2 or 3 days for if you are a patient in the hospital.
How to prepare for the testUsually, no special preparation is necessary.
Tell your doctor about any medications you are taking. Drugs that can increase CPK measurements include amphotericin B, ampicillin, certain anesthetics, blood thinners, aspirin, clofibrate, dexamethasone, furosemide, alcohol, and cocaine.
How the test will feelWhen the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performedWhen the total CPK level is very high, it usually means there has been injury or stress to the heart, the brain, or muscle tissue. For example, when a muscle is damaged, CPK leaks into the bloodstream. Determining which specific form of CPK is high helps doctor's determine which tissue has been damaged.
This test may be used to:
- Diagnose heart attack
- Evaluate cause of chest pain
- Determine if or how badly a muscle is damaged
- Detect early dermatomyositis and polymyositis
- Tell the difference between malignant hyperthermia and postoperative infection
- Reveal who carries muscular dystrophy(Duchenne)
The pattern and timing of a rise or fall in CPK levels can be diagnostically significant, particularly if a heart attack is suspected.
What abnormal results meanHigh CPK levels may be seen in patients who have:
- Heart attack
- Brain injury or stroke
- Inflammation of the heart muscle (myocarditis)
- Convulsions
- Delirium tremens
- Dermatomyositis or polymyositis
- Electric shock
- Lung tissue death (pulmonary infarction)
- Muscular dystrophies
Additional conditions may give positive test results:
What the risks areThere is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Other tests should be done to determine the exact location of muscle damage.
Factors that may affect test results include cardiac catheterization, intramuscular injections, trauma to muscles, recent surgery, and heavy exercise.
ReferencesAnderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 72.
Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 447.
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