The utility of creatine kinase in status dystonicus and pre-status dystonicus

IF 2.3 3区医学 Q3 CLINICAL NEUROLOGY

European Journal of Paediatric Neurology Pub Date : 2025-05-27 DOI:10.1016/j.ejpn.2025.05.013

Daniel E. Lumsden , Apostolos Papandreou , Nicholas M. Allen , Jean-Piere Lin

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引用次数: 0

Abstract

Background

Individuals with dystonia may experience acute exacerbations of symptoms.

Objectives

We aimed to explore the role of serum creatinine kinase (CK) levels as a biomarker for dystonia severity during episodes of exacerbation.

Methods

A retrospective review of admissions to a paediatric tertiary centre due to Status Dystonicus over a 5-year period. A comprehensive scoping review of the published literature for SD and pre-SD was also undertaken.

Results

In total 58 admissions for 45 patients were identified. Dystonia Severity Action Plan (DSAP) was Grade 3 (pre-SD) for 41/58 admissions and Grade 4–5 (SD) for 17 admissions. Length of admission was significantly longer for SD (P < 0.005), with poorer outcomes (Fishers Exact test P < 0.001). CK levels were measured in 24/41 episodes of pre-SD, and 16/17 episodes of SD. Median peak CK levels were higher (729 IU/L) in the SD compared to pre-SD group (179.5 IU/L) (p = 0.009). For patients with SD, serial CK measurements tracked dystonia severity over time. Literature review identified 201 episodes of SD in 190 subjects. Note was made of CK measurement in 92/201 (45.8 %) episodes: pre-SD (DSAP 3) in 8 and SD in 84 [DSAP 4 (n = 30), and DSAP 5 (n = 54)] respectively, with a numerical value provided in in 73/90 episodes/cases. Median CK value was 4066 IU/L (884–22,105, 25th to 75th Centile). In the literature review, for 11 episodes serial CK measures were shown to correlate with severity of dystonic symptoms.

Conclusions

serum CK levels represent a potentially useful biomarker for dystonia severity that differs between pre-SD and SD, and provide a measure to track dystonia severity at an individual patient basis.

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肌酸激酶在肌张力障碍状态和肌张力障碍前期的应用

背景：肌张力障碍患者可能会出现症状的急性加重。目的：探讨血清肌酐激酶（CK）水平作为肌张力障碍加重期严重程度的生物标志物的作用。方法回顾性分析某儿科三级中心5年期间因精神障碍入院的病例。对已发表的关于可持续发展和可持续发展前的文献进行了全面的范围审查。结果共收治58例患者45例。41/58例患者的肌张力障碍严重程度行动计划（DSAP）为3级（SD前），17例患者为4-5级（SD）。SD患者入院时间明显更长(P <；0.005)，结果较差(fisher精确检验P <；0.001)。在SD前24/41次发作和SD前16/17次发作时测量CK水平。SD组CK峰值中位数（729 IU/L）高于SD前组（179.5 IU/L）（p = 0.009）。对于SD患者，连续CK测量随时间跟踪肌张力障碍的严重程度。文献综述在190名受试者中发现201例SD。在92/201例（45.8%）病例中进行了CK测量：8例为预SD (DSAP 3)， 84例为SD [DSAP 4 （n = 30）和DSAP 5 (n = 54)]，其中73/90例提供了数值。中位CK值为4066 IU/L（884 - 22105, 25 - 75百分位）。在文献综述中，11次连续CK测量显示与肌张力障碍症状的严重程度相关。结论血清CK水平是一种潜在有用的肌张力障碍严重程度的生物标志物，在SD前和SD之间存在差异，并提供了一种以个体患者为基础的肌张力障碍严重程度的跟踪措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Paediatric Neurology 医学-临床神经学

CiteScore

6.30

自引率

3.20%

发文量

115

审稿时长

81 days

期刊介绍： The European Journal of Paediatric Neurology is the Official Journal of the European Paediatric Neurology Society, successor to the long-established European Federation of Child Neurology Societies. Under the guidance of a prestigious International editorial board, this multi-disciplinary journal publishes exciting clinical and experimental research in this rapidly expanding field. High quality papers written by leading experts encompass all the major diseases including epilepsy, movement disorders, neuromuscular disorders, neurodegenerative disorders and intellectual disability. Other exciting highlights include articles on brain imaging and neonatal neurology, and the publication of regularly updated tables relating to the main groups of disorders.