Investigation of conditions causing high creatine phosphokinase enzyme (CPK) in childhood

ABSTRACT Objective: In this study is to determine the conditions and diseases that cause elevated serum creatine phosphokinase enzyme, to investigate prognosis, mortality and morbidity, and to determine the appropriate approach for patients with high creatine phosphokinase in the light of this information. Materials and Methods: Patients between the ages of 0 and 18 who applied to Ondokuz Mayıs University Medical Faculty Hospital between 01.01.2016 and 21.05.2021 and whose serum creatine phosphokinase enzyme level was over 300 U/L wereanalyzedretrospectively to determining thecause of the serum creatine phosphokinase enzyme elevation and evaluating the patient prognosis. We examined anamnesis information, clinical course, laboratory values, radiologic examination and echocardiography results on Hospital Information Management System Records. In addition, McMahon score was calculated in patients in whom all creatinine, calcium, bicarbonate and phosphorus values were requested at initial presentation and its success in predicting the risk of morbidity and mortality in pediatric patients was examined. Results: Of a total of 3533 pediatric patients, 2402 (68%) were male and the mean age at presentation was 7.37 years. The most common causes were contusion (42.8%), infection (21.5%) and drug use (6.5%). No etiology was found in 20.1% of the patients. All diagnoses were significantly more common in males (p<0.001). Rhabdomyolysis was seen in 934 (26.4%) patients, renal failure in 45 (1.3%) and death in 87 (2.5%). In 111 patients, the mean McMahon score was 5.9, the mean score was (8) in patients with renal failure and (6.94) in patients who died, and the mean score was significantly higher in the renal failure (p=0.006) and death (p=0.007) groups. Conclusion: The risk of renal failure and death is higher in rhabdomyolysis caused by trauma, infectious diseases and hypoxia. The McMahon scoring system has been shown to be a guide in predicting prognosis.