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Creatine Kinase Isoenzyme Electrophoresis (CK)

CK Electrophoresis, Atypical CK, CK-BB, Macro CK, Creatine Kinase (CK) Isoenzyme Electrophoresis

Test Codes

EPIC: LAB5979, Beaker: XCKEL, Warde: CKISO

Department

Send Outs

Instructions

CK-MB isoenzyme electrophoresis determinations are done if the CK, Total is greater than 100 U/L.

Specimen Collection Criteria

Collect: One Gold-top SST tube.
Also acceptable: One plain Red-top tube.

Send specimen for processing after collection.

Physician Office/Draw Specimen Preparation

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within 4 hours of collection. Transfer serum to a plastic tube and refrigerate (2-8°C or 36-46°F) immediately.

Preparation for Courier Transport

Transport: 2.0 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL)

Rejection Criteria

• Grossly hemolyzed specimens.
• Specimens not collected and processed as indicated.

Inpatient Specimen Preparation

Deliver specimen to the Laboratory immediately after collection for processing.

In-Lab Processing

Let specimen clot 30-60 minutes then centrifuge to separate serum from cells within 4 hours of collection. Transfer serum to a plastic tube and refrigerate (2-8°C or 36-46°F) immediately.

Transport: 2.0 mL serum, refrigerated (2-8°C or 36-46°F). (Minimum: 0.5 mL) 

Storage

Specimen Stability for Testing:

Room temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 14 days

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions. 

Laboratory

Sent to Warde Medical Laboratory, Ann Arbor, MI.

Performed

Tuesday, Friday.
Results available in 3-6 days.

Reference Range

By report.

Note: Strenuous exercise or intramuscular injections may cause transient elevation of CK.

Test Methodology

Electrophoresis, Spectrophotometry.

Interpretation

CK-BB (CK-1) is present in relatively high concentration in brain, gastro-intestinal tract, prostate, uterus and placenta. Infarction or damage to any of these tissues may cause release of CK-BB which may be measured in blood and in some cases can result in elevation of total CK.

Atypical CK isoenzymes include macro CK-1 and macro CK-2. Macro CK-1 is an imunoglobulin bound CK which may cause the total CK to be elevated and may interfere with some CK-MB tests. The presence of macro CK-1 appears to have no major clinical significance.

Macro CK-2 is mitochondrial CK and is a true CK isoenzyme. Its presence in serum usually indicates poor patient prognosis and occurs in end-stage cirrhosis, metastatic disease or severe congestive heart failure.

Clinical Utility

CK isoenzymes by electrophoresis should be ordered to determine the presence/absence of CK-BB or atypical CK isoenzymes, or in questionable CK-MB results where test interference is suspected. It should not be ordered for management of chest pain patients - in these cases CK-MB should be requested.

CPT Codes

82550, 82552 (if indicated).

Contacts

Last Updated

10/2/2023