Differential Diagnosis for Mild Persistent Elevated CK Total

Single Most Likely Diagnosis

• Muscle strain or overuse: This is the most common cause of mild persistent elevated CK total, as muscle damage from strain or overuse can lead to a persistent increase in CK levels.

Other Likely Diagnoses

• Hypothyroidism: Hypothyroidism can cause an increase in CK levels due to muscle damage and decreased muscle function.
• Statins or other medication side effects: Certain medications, such as statins, can cause muscle damage and elevate CK levels.
• Chronic muscle disease (e.g., muscular dystrophy): Mild persistent elevated CK total can be seen in chronic muscle diseases, although the elevation is often more pronounced.

Do Not Miss Diagnoses

• Rhabdomyolysis: Although less likely, rhabdomyolysis is a life-threatening condition that requires immediate attention. It can cause a significant elevation in CK levels, and mild persistent elevation may be an early sign.
• Neuroleptic malignant syndrome: This rare but life-threatening condition can cause muscle damage and elevate CK levels.
• Malignant hyperthermia: This rare condition can cause a significant elevation in CK levels due to muscle damage.

Rare Diagnoses

• McArdle disease (glycogen storage disease type V): A rare genetic disorder that affects muscle glycogen metabolism and can cause elevated CK levels.
• Duchenne muscular dystrophy (late onset): A rare genetic disorder that affects muscle function and can cause elevated CK levels.
• Inflammatory myopathies (e.g., polymyositis, dermatomyositis): Rare autoimmune disorders that can cause muscle damage and elevate CK levels.