16 October 2022
: Case report 
Physiologic Response to Exercise or Rhabdomyolysis? Creatine Phosphokinase Elevation in 16 Asymptomatic Firefighters
Unusual clinical course, Challenging differential diagnosis
Rajia Arbab12ABCDEF*, Carla Erb12BCDE, Justin Joy2E, Hanady Zainah2EG, Majed Mark Samarneh3BEGDOI: 10.12659/AJCR.937084
Am J Case Rep 2022; 23:e937084
Table 2. Laboratory test values upon admission. Abnormal values are bolded and include the elevated CPK levels for all 4 patients in addition to elevated AST and ALT levels.
| Normal range | Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
|---|---|---|---|---|---|
| Creatinine (mg/dL) | 0.55–1.3 | 1.3 | 0.70 | 0.90 | |
| BUN (mg/dL) | 7–18 | 13.9 | 12.5 | 11.7 | |
| AST (U/L) | 15–37 | 2055 | |||
| ALT (U/L) | 13–61 | 55 | 555 | ||
| Alkaline phosphatase (U/L) | 45–117 | 62 | 47 | 35 | 67 |
| Creatine phosphokinase (U/L) | 26–308 | ||||
| Urine protein | Neg | Neg | Neg | Neg | Neg |
| Urine blood | Neg | Neg | Neg | Neg | Neg |
| BUN – blood urea nitrogen; AST – aspartate aminotransferase; ALT – alanine transaminase; CPK – creatine phosphokinase. | |||||