J Clin Pathol Qual Control.  1997 Dec;19(2):323-327.

Significance of CK-MB in Sera with Normal CK Level and Flipped LD Pattern in Sera with Normal LD Level

• Kwon HJ
• Seo EJ

Abstract

BACKGROUND: The presence of creatine kinase-MB (CK-MB) combined with flipped lactate dehydrogenase (LD) pattern is helpful for the diagnosis of acute myocardial infarction. Sometimes CK-MB with a normal CK level and/or flipped pattern with normal LD level are observed. So we studied to clarify the clinical significance of these CK-MB with normal CK level and/or flipped pattern with normal LD level in relation to myocardial infarction.
METHODS
We analyzed clinical records of 62 patients who showed CK-MB with normal CK level and/or flipped pattern with normal LD level among 4218 specimens which were requested for CK and LD isozyme electrophoresis.
RESULTS
Among 3 cases which had CK-MB with normal CK level and flipped pattern with normal LD level, 2 were diagnosed as acute myocardial infarction and 1 as unstable angina. Twenty three cases of 37 flipped LD with normal LD level were diagnosed as acute myocardial infarction. Eight cases of 20 CK-MB with normal CK level were diagnosed as acute myocardial infarction.
CONCLUSIONS
CK-MB with normal CK level and flipped pattern with normal LD level could be seen in acute myocardial infarction cases, so we should not overlook those findings even though CK or LD level is normal.

MeSH Terms

Angina, Unstable
Creatine
Diagnosis
Electrophoresis
Humans
L-Lactate Dehydrogenase
Myocardial Infarction
Creatine
L-Lactate Dehydrogenase