Falsely negative laboratory diagnosis for myocardial infarction owing to the concurrent presence of macro creatine kinase and macro lactate dehydrogenase.

1982 ◽  
Vol 28 (12) ◽  
pp. 2434-2437 ◽  
Author(s):  
M R Pudek ◽  
B E Jacobson
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Cellulose Acetate ◽  
Gel Filtration ◽  
Laboratory Diagnosis ◽  
Cellulose Acetate Electrophoresis

Abstract Macro creatine kinase (CK, EC 2.7.3.2) and macro lactate dehydrogenase (LD, EC 1.1.1.27) were both present in the serum of a 70-year-old woman with myocardial infarction. This interfered with the interpretation of the CK and LD isoenzyme analyses. Gel filtration and immunoprecipitation showed that the macro CK consisted of IgG and CK and the macro LD of IgG and LD. The IgG in this patient bound both MB and BB isoenzymes of CK, resulting in a macro CK complex that co-migrated with CK-MM on cellulose acetate electrophoresis. This situation led to a falsely negative laboratory diagnosis for myocardial infarction.

Creatine kinase isoenzymes in neonate plasma by cellulose acetate electrophoresis: albumin and adenylate kinase artifacts.

1982 ◽  
Vol 28 (5) ◽  
pp. 1174-1176 ◽  
Author(s):  
T H Massey ◽  
J S Barta
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Cellulose Acetate ◽  
Adenylate Kinase ◽  
Staining Method ◽  
Fluorescent Staining ◽  
Cellulose Acetate Electrophoresis ◽  
Creatine Kinase Isoenzymes ◽  
Apparently Healthy

Abstract Patterns of creatine kinase (CK, EC 2.7.3.2) isoenzymes were studied in apparently healthy one- to 10-day-old neonates, by use of a sensitive fluorescent staining method with Sclavo CK-F/6001 reagent. Mean activities of CK3 (MM, 105 U/L), CK2 (MB, 6.8 U/L), CK1 (BB, 11 U/L), adenylate kinase (EC 2.7.4.3) anodal to CK3, and a fluorescent albumin artifact were found. Pooled plasma from neonates is recommended as a control because it defines the albumin artifact and approximates the activity of CK2 that must be observed after proper staining before a diagnosis of myocardial infarction can be made.

ASSOCIATION OF SERUM LACTATE LEVELS WITH CREATINE KINASE – MB AND LACTATE DEHYDROGENASE IN PATIENTS WITH MYOCARDIAL INFARCTION

2021 ◽  
pp. 73-75
Author(s):  
Mallaiyan Manonmani ◽  
Meiyappan Kavitha
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Serum Lactate ◽  
Serum Creatine Kinase ◽  
Hemodynamic Management ◽  
Diagnosis And Prognosis ◽  
Creatine Kinase Mb ◽  
Enzymatic Markers ◽  
Lactate Levels

Objectives: Myocardial infarction is the most common form of coronary heart disease, the commonest cause of worldwide mortality. The present biochemical markers take atleast 6 hours for elevation following an episode of myocardial infarction. There is a need for sensitive marker for early diagnosis and prognosis. Lactate, the end product of anaerobic glycolysis is found to be elevated in many critical illnesses. Thus the study was undertaken to assess the levels of serum lactate in patients with myocardial infarction and to correlate it with the frequently used enzymatic markers for the diagnosis of myocardial infarction, i.e creatine kinase – MB and lactate dehydrogenase Methods: Fifty age and sex matched controls and fty cases of myocardial infarction were included in the study. Serum creatine kinase – MB, lactate dehydrogenase and lactate were estimated in these subjects. Results:The serum lactate levels were signicantly higher among cases when compared to controls. The serum lactate levels positively correlated with serum creatine kinase – MB among cases but not with lactate dehydrogenase. Conclusions: We conclude that serum lactate is altered in patients with myocardial infarction and may be considered as a prognostic risk factor in these patients. Further studies are needed to nd the cut-off value of serum lactate for assistance in the hemodynamic management of these patients.

Improved column method for separating lactate dehydrogenase isoenzymes 1 and 2.

1978 ◽  
Vol 24 (3) ◽  
pp. 480-482 ◽  
Author(s):  
D W Mercer
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Heart Disease ◽  
Lactate Dehydrogenase ◽  
Sodium Chloride ◽  
Lactate Dehydrogenase Activity ◽  
Column Method ◽  
Creatine Kinase Mb ◽  
Lactate Dehydrogenase Isoenzymes

Abstract Lactate dehydrogenase (LD) isoenzymes 1 and 2 in human serum were separated on a column of diethylaminoethyl-Sephadex. Samples layered on mini-columns were eluted with buffered sodium chloride (100, 150, and 200 mmol/liter). Lactate dehydrogenase activity in column effluents was measured by the Wacker method, and their isoenzyme content was evaluated by electrophoresis on polyacrylamide gel. Results for column-fractionated LD-1 and LD-2 were expressed in two ways: LD-1/LD-2 ratios and total LD-1 + LD-2 activities. The former is a more specific indicator of myocardial infarction than the latter. Sera from 10 patients with acute myocardial infarction (increased creatine kinease isoenzyme MB activity) exhibited ratios in the range of 0.92 to 1.56, ratios for 10 patients without heart disease (normal creatine kinase MB) ranged from 0.33 to 0.69.

Diagnosis of hemolytic disease by electrophoresis of erythrocyte lactate dehydrogenase isoenzymes on cellulose acetate or Agarose.

1981 ◽  
Vol 27 (8) ◽  
pp. 1453-1455 ◽  
Author(s):  
F Van Lente ◽  
A Marchand ◽  
R S Galen
Keyword(s):  
Lactate Dehydrogenase ◽  
Cellulose Acetate ◽  
Predictive Value ◽  
In Vitro Models ◽  
Hemolytic Disease ◽  
Cellulose Acetate Electrophoresis ◽  
Lactate Dehydrogenase Isoenzymes

Abstract We determined the LD-1/LD-2 isoenzyme ratio in hemolysates of erythrocytes by electrophoresis on cellulose acetate and on agarose. A ratio exceeding 1.0 was found with the former but not the latter. Results were similar for in vitro models of hemolytic disorders. Using cellulose acetate electrophoresis, we determined the predictive value of data on total LD activity and of the LD-1/LD-2 ratio in diagnosis of hemolytic disease in 100 patients. The sensitivity of the "flipped" LD-1/LD-2 ratio was only 58%, the specificity was 93%, and the predictive value was 74% for diagnosis of hemolytic disease. A normal total LD activity is highly predictive (92%) for ruling at the presence of hemolytic disease.

Creatine kinase isoenzymes of mitochondrial origin in human serum.

1979 ◽  
Vol 25 (6) ◽  
pp. 943-947 ◽  
Author(s):  
G P James ◽  
R L Harrison
Keyword(s):  
Skeletal Muscle ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Serum Samples ◽  
Muscle Creatine Kinase ◽  
Cellulose Acetate Electrophoresis ◽  
University Of Texas ◽  
Creatine Kinase Isoenzymes ◽  
Mitochondrial Origin ◽  
Muscle Creatine

Abstract We measured creatine kinase (EC 2.7.3.2) activity in 1009 serum samples from 538 patients in the intensive-care units of the University of Texas Medical Branch hospitals. Creatine kinase isoenzymes migrating cathodal to skeletal muscle creatine kinase (CK-MM) on cellulose acetate electrophoresis were found in sera from 14 of the 538 patients. Creatine kinase, lactate dehydrogenase (EC 1.1.1.27), aspartate aminotransferase (EC 2.6.1.1), and alanine aminotransferase (EC 2.6.1.2) activities were abnormally increased in these 14 patients. Liver lactate dehydrogenase isoenzyme (LDH5) and cardiac creatine kinase isoenzyme (CK-MB) were abnormally increased in 12 and eight of these patients, respectively. Ten of the 14 patients died during their hospital admission. We believe the creatine kinase isoenzymes that migrated cathodal to skeletal muscle creatine kinase (CK-MM) were of mitochondrial origin.

Information induction for predicting acute myocardial infarction.

1988 ◽  
Vol 34 (10) ◽  
pp. 2031-2038 ◽  
Author(s):  
R A Rudolph ◽  
L H Bernstein ◽  
J Babb
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Information Theory ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Noisy Channel ◽  
Information Uncertainty ◽  
Test Results ◽  
Creatine Kinase Mb

Abstract We show how to make an unsupervised discrimination of disease and nondisease states by measuring information and using newer notions of inductive reason. We also present a new theory of group-based reference values that is based on measuring information uncertainty. We use data on the isoenzymes creatine kinase-MB (CK-MB) and lactate dehydrogenase-1 (LD1) and on the percentage of LD1 from 101 patients with acute myocardial infarction (AMI) and from 41 patients with suspected, but unfounded, infarction (non-AMI). Calculating the Shannon entropy, a concept from information theory, of the data base allows determination of a difference in entropy values ("effective information"), which determines decision cutoff values that produce binary-base patterns yielding the fewest classification errors. Redundancy in testing is important because it provides the information to approach a goal of errorless discrimination by coding the test results and meeting the conditions of the "Noisy Channel Theorem" of information theory. This redundancy improves the predictive value of diagnosis by isolating the area of equivocation to evident patterns. Results for CK-MB and LD1 are 99% correct in assigning cases to AMI and non-AMI categories; adding %LD1 increases the proportion of errorless binary patterns from 25% to 90%.

Creatine kinase MB-isoenzyme evaluated by cellulose acetate electrophoresis.

1983 ◽  
Vol 29 (7) ◽  
pp. 1442-1443 ◽  
Author(s):  
P Gillery ◽  
D Marnot ◽  
P Ramain ◽  
J P Borel
Keyword(s):  
Creatine Kinase ◽  
Cellulose Acetate ◽  
Cellulose Acetate Electrophoresis ◽  
Creatine Kinase Mb

Reasonableness of Use of the Serum Isoenzymes Creatine Kinase and Lactate Dehydrogenase for the Diagnosis of Myocardial Infarction at a Medical Center

1980 ◽  
Vol 74 (2) ◽  
pp. 202-204 ◽  
Author(s):  
Myrton F. Beeler ◽  
Paul G. Catrou ◽  
James E. Grogan ◽  
Margaret C. Oalmann ◽  
Robert W. Sappenfield
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Medical Center
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