TY - JOUR
T1 - Absence of myoglobinuria in acute psychotic patients with marked elevation in serum creatine phosphokinase level
AU - Hermesh, Haggai
AU - Manor, Iris
AU - Shiloh, Roni
AU - Weizman, Ronit
AU - Munitz, Hanan
PY - 2001
Y1 - 2001
N2 - Elevated levels of serum creatine phosphokinase, muscular type (CKMM) are caused primarily by diseased muscle fiber. Acute psychoses are often associated with a marked increase in serum CKMM levels, though the reason remains obscure. Since striated muscle damage is also associated with pigmenturia and myoglobinuria, we sought to determine whether the markedly high serum CK level of acute psychosis reflects skeletal muscle damage by evaluating urinary myoglobin in affected patients. Baseline serum CK was measured on admission in 713 consecutive acute psychotic inpatients (BPRS≥40). Those showing a serum CK levels above 1000 IU/l on the first 2 days of hospitalization underwent urine collection for myoglobin testing. Patients with physical trauma or medical conditions known to cause CKemia were excluded. Twenty-five patients were eligible for the study. In no case did myoglobinuria or pigmenturia accompany the marked CKemia. There is an unexpected dissociation between the robust increase in the serum CKMM levels and the absence of myoglobinuria in acute psychosis. Our negative finding may indicate that the serum CK threshold for myoglobinuria is very high (above 10 000 IU/l). Alternatively, psychosis-associated CKemia may be related to an unknown, nontraumatic, pathophysiological mechanism(s).
AB - Elevated levels of serum creatine phosphokinase, muscular type (CKMM) are caused primarily by diseased muscle fiber. Acute psychoses are often associated with a marked increase in serum CKMM levels, though the reason remains obscure. Since striated muscle damage is also associated with pigmenturia and myoglobinuria, we sought to determine whether the markedly high serum CK level of acute psychosis reflects skeletal muscle damage by evaluating urinary myoglobin in affected patients. Baseline serum CK was measured on admission in 713 consecutive acute psychotic inpatients (BPRS≥40). Those showing a serum CK levels above 1000 IU/l on the first 2 days of hospitalization underwent urine collection for myoglobin testing. Patients with physical trauma or medical conditions known to cause CKemia were excluded. Twenty-five patients were eligible for the study. In no case did myoglobinuria or pigmenturia accompany the marked CKemia. There is an unexpected dissociation between the robust increase in the serum CKMM levels and the absence of myoglobinuria in acute psychosis. Our negative finding may indicate that the serum CK threshold for myoglobinuria is very high (above 10 000 IU/l). Alternatively, psychosis-associated CKemia may be related to an unknown, nontraumatic, pathophysiological mechanism(s).
KW - Creatine phosphokinase
KW - Muscle
KW - Myoglobin
KW - Neuroleptic malignant syndrome
KW - Psychosis
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=0035061640&partnerID=8YFLogxK
U2 - 10.1016/S0924-977X(00)00139-5
DO - 10.1016/S0924-977X(00)00139-5
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AN - SCOPUS:0035061640
SN - 0924-977X
VL - 11
SP - 111
EP - 115
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 2
ER -