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Author Topic: Macro CK Type II  (Read 3511 times)

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Offline John2038

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Macro CK Type II
« on: April 16, 2010, 10:48:30 AM »
has anyone experiment a positive Macro CK Type II ?
If so, has the cause been identified (such as TDF), and how as it evolve ?

My CK Total is within the normal range 109 (n.r. <190).
94.5% of it belongs to CK-MM, but 5.5% Macro CK Type II.

I guess it is due to the TDF in my current regimen, or/and probably a NAFLD.
My AST/ALT are slightly elevated but not too worrying (54/127), and my gamma-GT is normal (27).

Thanks

John

Offline Inchlingblue

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Re: Macro CK Type II
« Reply #1 on: April 16, 2010, 12:52:03 PM »
Is this the same as CPK (creatine phosphokinase)?

Elevated CPK levels is one of the few side effects that are known to happen with some people taking Isentress.

LINK:

http://www.aidsmap.com/en/news/82A67A30-B689-46D7-9BAB-2DE43B46AA8C.asp

Offline veritas

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Re: Macro CK Type II
« Reply #2 on: April 16, 2010, 01:43:13 PM »

John,


"Another concern with tenofovir was raised by the observation of Schmid and colleagues, who found a significant association between the use of tenofovir and the presence of the enzyme variant “macroenzyme creatine kinase type 2” (Macro CK2). Electrophoresis and immunoblotting demonstrated that the Macro CK2 in TDF-treated patients consisted of the ubiquitous mitochondrial creative kinase (uMtCK) suggesting that the appearance of uMtCK in these patients might be a first indicator of mitochondrial toxicity of TDF in the kidney (Schmid et al 2006)."

John, you are correct. Tenofovir can cause issues with CK2. However, the dose can be adjusted to help the problem. See the study where this was observed:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2500249/?tool=pubmed

Always something ! I'm keeping a watchful eye on my CPK also.

v

Offline Inchlingblue

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Re: Macro CK Type II
« Reply #3 on: April 16, 2010, 02:33:32 PM »

Always something ! I'm keeping a watchful eye on my CPK also.

v

I don't think CK Type II is the same as CPK, it can get confusing.

Offline veritas

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Re: Macro CK Type II
« Reply #4 on: April 16, 2010, 03:23:26 PM »

Inch,

They are not the same. I can see how my post would have confused you. I meant I am watching CPK in addition to other blood levels, kinda in response to your post. Sorry for the confusion. Here's the study directly for macro ck type 2:



http://www.ncbi.nlm.nih.gov/pubmed/17302377

Here's another study:

http://www.retroconference.org/2005/CD/PDFs/827.pdf

Here's the definition of CPK:


http://www.nlm.nih.gov/medlineplus/ency/article/003503.htm


v

Offline John2038

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Re: Macro CK Type II
« Reply #5 on: April 16, 2010, 06:37:00 PM »
Hi guys,

and thanks for your replies !

About the CK Total (or CPK), just to say that it was 6'500 two weeks ago and to fall 109 one week after:

this very high elevation was due to the gym. I was not even exercising a lot, just 45min to 1h cycling per day, and some weight training.

I have stop training for a week to get my CK checked again, and it fall to 109.

Just sharing

John

Offline veritas

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Re: Macro CK Type II
« Reply #6 on: April 17, 2010, 05:52:07 AM »

John,

Good to hear John ---- we'll beat this yet !


v

Offline Inchlingblue

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Re: Macro CK Type II
« Reply #7 on: April 17, 2010, 02:33:50 PM »
Is elevated Macro CK Type 2 a sign of kidney damage?  

Some of the literature Veritas posted seems to suggest that but John keeps mentioning muscle damage (which is why I was confused with CPK elevation, which does have to do with muscle damage).

Offline veritas

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Re: Macro CK Type II
« Reply #8 on: April 17, 2010, 04:14:54 PM »

Inch,

According to this study, CK seems to affect blood pressure and elevated CK levels can be manifested by damaged muscles.

http://circ.ahajournals.org/cgi/reprint/114/19/2034

"A common cause of elevated serum CK activity levels is
exercise.27 The resting period of 3 days should have substantially
reduced the effect of exercise on serum CK, but CK
activity can be elevated up to 3 weeks after eccentric
muscular activity (in which muscle contracts and lengthens at
the same time)"

The above quote from the study reaffirms John's suggestion of muscle damage.

v

Offline John2038

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Re: Macro CK Type II
« Reply #9 on: April 17, 2010, 04:41:29 PM »
Inch,

Macro CK2 is frequently associated with hepatitis or necrotic pathologies.

The Total CK (Total CPK)  comes in four different forms:
CK-MM (muscle type), CK-BB (brain type) and CK-MB (myocardial type).

My Total CK was made of 94.5% of CK-MM (n.r. 90.0-100.0) but also 5.5% of Macro-CK2 (n.r. 0.0)

Malignancies may hide behind a positive Macro-CK2, but fortunately not always. TDF may also be the culprit as well as others no worrying causes as well.

Just to share about the CK, I have also mention my Totla CK. It was of 6'500 the week I was still exercising, to fall to 109 (n.r. < 190) a week after, without exercising. The CK Total may be elevated after exercising, and it was the case for me. But the Macro-CK2 was positive, and I was wondering if others have had as well.

Thanks

John
« Last Edit: April 17, 2010, 05:03:15 PM by John2038 »

Offline Inchlingblue

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Re: Macro CK Type II
« Reply #10 on: April 17, 2010, 06:28:41 PM »
What's confusing is that CPK measures muscle breakdown and it has nothing to do with CK.

Creatinine & CPK

Joel E. Gallant, M.D., M.P.H.

Posted on Aug 28, 2009

I know that serum creatinine levels are used to determine GFR and helps in measuring kidney health/function.

I also read that there is a small percentage of people on Isentress that experience elevated CPK levels (creatine phosphokinase).

My question is: are these two different things (creatinine and CPK)?

On Aug 29, 2009 Joel E. Gallant, M.D., M.P.H. replied:

Yes, despite the similarity in names, they are very different. The creatinine measures kidney function. The creatine phosphokinase (CPK) looks for muscle breakdown.


LINK:

http://www.hopkins-hivguide.org/q_a/patient/laboratory_tests/other_lab_tests/creatinine___cpk.html?contentInstanceId=500208

Offline John2038

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Re: Macro CK Type II
« Reply #11 on: April 17, 2010, 07:07:46 PM »
CPK is the former name, CK the new name. Both are synonyms. Dr Gallant is talking about the difference between the Creatinine and the Creatine Kinase.

Offline Inchlingblue

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Re: Macro CK Type II
« Reply #12 on: April 17, 2010, 07:14:17 PM »
Isentress can also possibly raise CPK. Assurbanipal had to stop for that reason.

What meds are you on?

Offline John2038

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Re: Macro CK Type II
« Reply #13 on: April 18, 2010, 07:50:51 AM »
Hi Inch,

I am on Stocrin/Viread (Atripla). BTW, I am not worrying about my lab, but willing to know if others have got similar results (while on TDF let says).

Cheers,

John

 


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