1986 Volume 28 Issue 6 Pages 829-835
We presented two cases of chronic renal failure on maintenance hemodialysis, presenting macro CK (creatine kinase). The first case, 53 year-old, male, patient, has showed 500-1500IU/l of serum CK level since, which was within normal range at the start of HD therapy in. He complained of no myalgic pain or muscle atrophies. On the electrophoresis of CK isoenzyme in the serum of this patient, so called "extrabands" were detected in a broad of MM and between MM and MB bands. These components has been proved to be heat stable by heating at 56°C for 5 min. Enzyme-immunofixation electrophoresis revealed that the heavy chain of CK-linked immunoglobulin was of class α. The light chain type was identified as both κ and λ. The another case, 41 year-old, male, patient, showed macro CK linked to IgA, κ, λ during the course of maintenance hemodialysis. There were no signs suggesting the presence of malignancies in these cases. Several papers described that serum level of CK frequently increased in the patients on maintenance hemodialysis and there was a significant correlation between the serum CK level and pre-dialysis BUN level, macro CK, however, has never been detected in the patients on maintenance hemodialysis. Macro CK has been noticed in patients with some malignancies, but we could not detect any malignancies in our two cases. Therefore, some immune dyscrasia might be involved in the production of macro CK in chronic renal failure.
