ПОВЫШЕНИЕ КРЕАТИНФОСФОКИНАЗЫ КАК ДИАГНОСТИЧЕСКАЯ ПРОБЛЕМА У МУЛЬТИМОРБИДНОГО ПАЦИЕНТА С COVID-19 (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ)

Abstract

Background. Creatine phosphokinase is an enzyme that is often associated with muscle and myocardial disorders. However, other causes of elevated level of this enzyme are possible, such as stroke, hypothyroidism, paraneoplastic syndrome, as well as various pharmacological effects, including taking statins and the development of statin-associated muscle symptoms, the consequences of a previous coronavirus infection COVID-19. The aim of the work. To determine the cause of increased creatine phosphokinase in a patient after coronavirus infection associated with concomitant diseases; to carry out differential diagnosis of an increase in this enzyme. Results. We carried out an analysis of the patient’s medical history with a significantly increased creatine phosphokinase and subsequent differential diagnosis in order to identify the main causes of this change. The study was performed based on the assessment of general medical condition of the patient, as well as of the results of complete and bio-chemical blood counts (including the level of creatine phosphokinase and lactate dehydrogenase). Instrumental studies such as electroneuromyography, electrocardiography, echocardiography and ultrasound scanning were also carried out. The patient was diagnosed with ischemic cardiovascular disease and hypothyroidism. However, the increased creatine phosphokinase was not associated with statin use, since it was discontinued during observation, and the enzyme level increased over time. Other causes of increased creatine phosphokinase were also excluded, and the results indicate that the increase in this enzyme is likely caused by a previous coronavirus infection with concomitant diseases. Conclusion. The present study highlights the importance of a comprehensive approach to the differential diagnosis and treatment of increased creatine phosphokinase levels in patients with comorbid pathology, as this may be a con-sequence of various factors, including infections, concomitant diseases and pharmacological intervention.