Elevated serum creatine kinase activity in a patient with acute pancreatitis

A 62-year-old man presented with a five-day history of a 'flu-like' illness , epigastric pain and a state of increasing confusion, His serum values for amylase and glucose were grossly elevated, as was the creatine kinase (CK) activity, being 23 times above the upper limit of normal, OK-MB was less t han 5% of his total CK activity. There was no past history of diabetes or r ecent history of intramuscular injections or injury. A diagnosis of acute p ancreatitis complicated by hyperosmolar non-ketotic (HONK) diabetic pre-com a was made. The patient was treated with intravenous fluids, insulin and su bcutaneous heparin. Normal values for serum amylase and CK activity were re corded with convalescence. This case indicates a possible association of a rise in total CK activity with acute pancreatitis complicated by HONK diabe tic pre-coma. This observation was made in the absence of clinically eviden t muscle pathology.