CREATINE PHOSPHOKINASE-LINKED IMMUNOGLOBULIN ASSOCIATED WITH HYPOKALEMIC MYOPATHY

We present three women with hypokalemic myopathy in whom serum creatin e phosphokinase (CPK) was bound to serum immunoglobulin (macro-CPK), I n all three cases, CPK isozyme electrophoresis demonstrated an extra C PK band between CPK-MM and CPK-MB, The bound immunoglobulins were iden tified as IgA/A-kappa and lambda, IgA-lambda and IgA-kappa and lambda, respectively, In all cases, histological examination of the biopsied muscles revealed necrotic and/or regenerating fibers, In each patient, potassium replacement therapy returned the macro-CPK as well as the m arked elevations of serum muscle enzymes to normal, Taken together wit h other recent reports, our findings suggested that CPK-immunoglobulin binding may be related to the emergence of pathophysiology of hypokal emic myopathy.