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 3. Laboratory values on follow-up. Patient 1 was tested 4 days after discharge, patient 2 was tested 3 days after discharge, and patients 3 and 4 were tested 1 day after discharge. All 4 patients’ CPK levels were still above the normal range, but the values showed a downtrend since discharge. Abnormal values are bolded.
| Normal range | Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
|---|---|---|---|---|---|
| Creatinine (mg/dL) | 0.60–1.35 | 1.28 | 0.87 | 1.01 | 1.18 |
| BUN (mg/dL) | 7–25 | 15 | 14 | 13 | 15 |
| AST (U/L) | 10–40 | ||||
| ALT (U/L) | 9–46 | 45 | 64 | ||
| Alkaline phosphatase (U/L) | 36–130 | 56 | 45 | 40 | 62 |
| Creatine phosphokinase (U/L) | 44–196 | ||||
| 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. | |||||