Neuro residents: Clincial ?

[MJD503]

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I work in Psych, as a Therapist. We recently had a patient with a CK level in the 4,000 range. How serious is this, in the big scheme of things? Does a 1,000 CK level deserve hospitalization? Rule out Neuroleptic Maglignant Syndrome was the cause of hospitalization... Psychotropic related

Thanks ahead for any information.

 

[neurologist]

I work in Psych, as a Therapist. We recently had a patient with a CK level in the 4,000 range. How serious is this, in the big scheme of things? Does a 1,000 CK level deserve hospitalization? Rule out Neuroleptic Maglignant Syndrome was the cause of hospitalization... Psychotropic related

Thanks ahead for any information.

Considering that most physicians have seen CK levels well into the tens of thousands (I've seen 100K), 4,000 is pretty tame. The bigger question is not so much CK level per se but associated renal and hepatic function. Whether a 1000 CK deserves hospitalization depends on the clinical scenario. Otherwise healthy person who just had some kind of one time trauma or extreme exertion, and renal function OK? Probably not, but you would want to check their level the next day to make sure it's not going up. Maybe give a couple bags of fluid to be sure. Unreliable psych patient who swallowed his whole bottle of haldol? That's an admit. And then you have the categories of patients who may have myopathies and basically "live" at an abnormally high CK level with no particular ill effects, as well as patients who just run sort of an idiopathic high CK for no apparent reason.