Two weeks post-infusion, the patient presented with dark colored urine and elevated creatine phosphokinase
(CK) levels but was otherwise asymptomatic.
Laboratory investigations of the patient revealed elevated muscle enzymes: creatine phosphokinase
as 922 U/L (0-171 U/L), aspartate aminotransferase as 85 U/L (0-50 U/L), and alanine aminotransferase as 157 U/L (0-50 U/L).
The most common grade 3 or 4 adverse events seen in at least 10% of patients were fatigue, anemia, increased creatine phosphokinase
, increased aspartate aminotransferase and urinary tract infections.
Recent studies indicate that creatine phosphokinase
(CPK) and lactate dehydrogenase (LDH) are two such markers that can be used in the diagnosis of different pathogens.
In addition to the low leukocyte and platelet counts, elevated ALT, creatine phosphokinase
, and lactate dehydrogenase levels were revealed by laboratory tests on day 6.
One patient experienced an increase in creatinine phosphokinase
, something that has been seen in other studies of JAK inhibitors, Dr.
Eight patients had elevated peak creatine phosphokinase
levels indicating skeletal muscle damage (median = 2,821 [micro]g/L; range = 566-25,467 [normal <200 [micro]g/L]), and seven had elevated peak lactic acid levels, which is an indicator of sepsis (median = 3.1 mmol/L; range = 2.3-5.3 [normal = 0.5-2.2 mmol/L]).
Hypertension, elevated blood creatinine phosphokinase
, and hot flushes were common adverse events (5 percent of greater in either ulipristal group during treatment).
Because of persistent poor renal function, a creatinine phosphokinase
(CPK) level was sent, which returned highly elevated at 129,940 (IU/L) (reference range 22-232 IU/L).
Laboratory diagnosis is essential based on the measurement of biomarkers of muscle injury, with creatinine phosphokinase
being the biochemical "gold standard" for diagnosis and myoglobin the "gold standard" for prognostication, especially in patients with nontraumatic rhabdomyolysis.
Results of blood tests showed severely elevated creatine Phosphokinase
(CPK) and aspartate aminotransferase (AST) activities, confirming suspected capture myopathy.