ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 300

Causes of Creatine Kinase Levels Greater Than 1,000 IU/L in Patients Referred to Rheumatology

David Leverenz1, Oana Zaha2, Leslie J. Crofford1 and Cecilia P. Chung3, 1Medicine, Vanderbilt University, Nashville, TN, 2Medicine, Div of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, 3Medicine, Div of Rheumatology & Immunology, Vanderbilt University, Nashville, TN

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Idiopathic Inflammatory Myopathies (IIM) and creatinine kinase

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 8, 2015

Title: Muscle Biology, Myositis and Myopathies Poster

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Patients with significantly elevated creatine kinase (CK) levels are commonly referred to rheumatologists to evaluate for the presence of an idiopathic inflammatory myopathy (IIM). However, no studies have evaluated the frequency with which IIMs are encountered in this clinical scenario. The purpose of this study was to define the causes of elevated CK levels in patients referred for rheumatology consultation with a CK greater than 1,000 IU/L and to examine the clinical characteristics of these patients to determine if any distinguishing factors could be discerned.

Methods: The Vanderbilt Synthetic Derivative, a de-identified copy of over 2 million patient charts, was searched to identify patients with a CK greater than 1,000 IU/L. Other inclusion criteria were age greater than 18 and containing a document with the word rheumatology. Patients were excluded if rheumatology involvement was unrelated to the elevated CK or if there was inadequate follow-up. These criteria identified 192 patients who were assigned a diagnosis using a pre-defined algorithm. Patients determined to have an IIM were classified using the Bohan and Peter criteria for dermatomyositis (DM) and polymyositis (PM), the Griggs criteria for inclusion body myositis (IBM), or by clinical diagnosis for patients with an overlap syndrome, necrotizing myopathy, or DM/PM not meeting the above criteria. To ensure diagnostic consistency and accuracy, 10% of the charts were examined by an independent reviewer. Each chart was reviewed for pertinent demographic data and clinical characteristics.

Results: A total of 105 (55%) patients were diagnosed with an IIM. The majority of the IIM patients met Bohan and Peter criteria for DM (n=24, 13%), PM (n=41, 21%), or were diagnosed clinically with an overlap syndrome (n=28, 15%). The rest of the IIM patients were diagnosed with a necrotizing myopathy (n=2, 1%), IBM (n=1, <1%), or an IIM not meeting criteria (n=9, 5%). The non-IIM causes were drug or toxin exposure (n=16, 8%), infection (n=12, 6%), trauma (n=10, 5%), myocardial injury (n=5, 3%), hypothyroidism (n=4, 2%), muscular dystrophy (n=4, 2%), neuropsychiatric disorder (n=3, 2%), glycogen storage disorder (n=1, <1%), mitochondrial myopathy (n=1, <1%), idiopathic CK elevation (n=11, 6%), and other diagnoses (n=20, 10%). Several characteristics were found to be significantly different between IIM and non-IIM cases. Patients with an IIM were more likely to be younger (average age 48 vs. 53, p=0.04), female (71% vs. 40%, p<0.001), seen in clinic and not as an inpatient (78% vs. 44%, p<0.001), have symptoms longer than 6 months (55% vs. 29%, p<0.001), have an ANA greater than or equal to 1:40 (54% vs. 24%, p<0.001), and have a positive Jo-1 antibody (11% vs. 0%, p=0.001). Patients without an IIM had more cardiac and renal comorbidities (61% vs. 31%, p<0.001 and 16% vs. 3%, p=0.002 respectively). There was no significant difference between the CK levels of patients with IIM vs. non-IIM.

Conclusion: More than half of patients referred for rheumatology consultation with a CK greater than 1,000 IU/L were diagnosed with an IIM. Given the importance of prompt diagnosis and treatment, rapid assessment by the consulting rheumatologist for these patients is recommended.


Disclosure: D. Leverenz, None; O. Zaha, None; L. J. Crofford, None; C. P. Chung, NIH, 2.

To cite this abstract in AMA style:

Leverenz D, Zaha O, Crofford LJ, Chung CP. Causes of Creatine Kinase Levels Greater Than 1,000 IU/L in Patients Referred to Rheumatology [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/causes-of-creatine-kinase-levels-greater-than-1000-iul-in-patients-referred-to-rheumatology/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/causes-of-creatine-kinase-levels-greater-than-1000-iul-in-patients-referred-to-rheumatology/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology