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MB Creatine Phosphokinase in Skeletal Muscle

Robert Roberts, MD; Burton E. Sobel, MD
Arch Intern Med. 1977;137(8):1089. doi:10.1001/archinte.1977.03630200091027.
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To the Editor.—  As Drs Adornato and Engel point out, Duchenne muscular dystrophy exhibits elevated plasma MB creatine phosphokinase (CPK) levels and several investigators have documented the presence of MB CPK in skeletal muscle and in the plasma from this particular group of patients. In our study (Archives 136:421-424, 1976) we were concerned with normal skeletal muscle because of the need to differentiate CPK level elevations due to muscle trauma in otherwise normal patients from elevations due to myocardial infarction. We, as others, have observed elevated levels of plasma MB CPK activity in patients with Duchenne muscular dystrophy and also in patients with polymyositis.1 The suggested explanation to account for the MB CPK in neuromuscular disorders is in keeping with the facts known regarding CPK ontongeny. However, it is important to note that patients with Duchenne muscular dystrophy also have active necrosis of myocardium that may account for the


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