Elevation of creatine kinase from skeletal muscle associated with inhaled albuterol

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
T J CraigV Soontornniyomkiu

Abstract

Elevations of creatine kinase have been described, but have been associated with high doses of albuterol given by oral or intravenous routes. Most reports have described an elevation of MB isoenzyme fraction from the heart. Elevation of creatine kinase-MM isoenzyme from skeletal muscle rarely appears to be associated with the use of inhaled albuterol. A patient is discussed who presented with severe myalgias and was found to have elevated creatine kinase-MM from albuterol metered dose inhaler. Clinical status, creatine kinase levels, electromyography, enzyme stains, histopathologic and lactate challenge studies were done to evaluate the status of the patient. Without exercise or use of albuterol, creatine kinase-MM levels were normal. With the use of albuterol, whether inhaled or by oral therapy, the creatine kinase-MM level increased. When combined with exercise, higher levels occurred. Workup was normal except histopathology revealed a myopathy. Patients with myalgias from albuterol with elevated creatine kinase-MM fraction should be investigated for possible myopathy.

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Citations

Apr 10, 2015·Medicine and Science in Sports and Exercise·Sarah KochMichael Stephen Koehle
Aug 25, 2016·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Hongmei QiaoJianing Yin
Jan 17, 2002·Rheumatology·J-P HellierF Berenbaum
Apr 2, 2021·Annals of Clinical and Translational Neurology·Maren FreigangRené Günther

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