Test ID: CK
Creatine Kinase (CK), Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
The determination of creatine kinase is utilized in the diagnosis and monitoring of myocardial infarction and myopathies such as the progressive Duchenne muscular dystrophy.
Method Name A short description of the method used to perform the test
Photometric, Creatine Phosphate + ADP
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
CPK (Creatine Phosphokinase)
Creatine Phosphokinase
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.5 mL
Additional Information: Patient's age and sex are required.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild reject; Gross reject |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 7 days |
| Frozen | 28 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Creatine Kinase (CK) activity is greatest in striated muscle, heart tissue, and brain. The determination of CK activity is a proven tool in the investigation of skeletal muscle disease (muscular dystrophy) and is also useful in the diagnosis of myocardial infarction (MI) and cerebrovascular accidents. Increased levels of CK also can be found in viral myositis, polymyositis, and hypothyroidism.
Following injury to the myocardium, such as occurs in acute MI, CK is released from the damaged myocardial cells. A rise in the CK activity can be found 4 to 8 hours after an infarction. CK activity reaches a maximum after 12 to 24 hours and then falls back to the normal range after 3 to 4 days.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Males
6-11 years: 150-499 U/L
12-17 years: 94-499 U/L
> or =18 years: 52-336 U/L
Females
6-7 years: 134-391 U/L
8-14 years: 91-391 U/L
15-17 years: 53-269 U/L
> or =18 years: 38-176 U/L
Reference values have not been established for patients that are less than 6 years of age.
Note: Strenuous exercise or intramuscular injections may cause transient elevation of CK.
Interpretation Provides information to assist in interpretation of the test results
Serum creatine kinase (CK) activity is greatly elevated, at some time during the course of the disease, in all types of muscular dystrophy, and especially so in Duchenne's type, in which levels up to 50 times the upper limit of normal may be encountered. In progressive muscular dystrophy, enzyme activity in serum is highest in infancy and childhood (7-10 years of age) and may be elevated long before the disease is clinically apparent. Quite high values of CK are noted in viral myositis, polymyositis, and similar muscle diseases. However, in Neurogenic Parkinsonism, serum enzyme activity is normal. Very high activity is also encountered in malignant hyperthermia.
An early rise in CK is also seen after an acute MI, with values peaking at 12 to 24 hours and falling back to normal in 3 to 4 days. Although total CK activity has been used as a diagnostic test for MI, it has been replaced by the troponin T and I immunoassays, and is no longer the laboratory test choice for diagnosing and monitoring acute infarctions. Serum CK activity may increase in patients with acute cerebrovascular disease or neurosurgical intervention and with cerebral ischemia. Serum CK activity also demonstrates an inverse relationship with thyroid activity. About 60% of hypothyroid subjects show an average elevation of CK activity 5-fold over the upper reference limit; elevation of as high as 50-fold may also be found.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Exercise and muscle trauma (contact sports, traffic accidents, intramuscular injections, surgery, convulsions, wasp or bee stings, and burns) can elevate serum creatine kinase values.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
Tietz Textbook of Clinical Chemistry, Edited by CA Burtis, ER Ashwood, WB Saunders Company, Philadelphia, 1999
Method Description Describes how the test is performed and provides a method-specific reference
Creatine kinase (CK) is determined by a coupled enzyme reaction where the rate of NADPH formation is measured photometrically and is directly proportional to the CK activity. (Package insert: Roche CK reagent. Indianapolis, IN, July 1999)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Sunday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
82550
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| CK | Creatine Kinase (CK), S | 2157-6 |
External
link
PDF
document
Excel
document
Word
document