Clinical Chemistry
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Clinical Chemistry 40: 177-183, 1994;
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Clinical Chemistry, Vol 40, 177-183, Copyright © 1994 by American Association for Clinical Chemistry

Is determination of creatine kinase-2 after electrophoretic separation accurate?

AR Henderson, JA Stark, MJ McQueen, RL Patten, S Krishnan, DE Wood and S Webb
Laboratory Proficiency Testing Program, Toronto, Ontario, Canada.

Since 1991, the Ontario Laboratory Proficiency Testing Program has assessed the analytical performance of creatine kinase (CK; EC 2.7.3.2) isoenzyme-2, using fresh human serum supplemented with purified human CK isoenzymes. In Ontario, the 142 laboratories licensed to analyze CK- 2 use a variety of methods: electrophoresis-based, immunoinhibition, and mass assays. During a 1992 survey, duplicate CK-2 samples with different total CK activities showed poorer precision when analyzed after electrophoretic separation than by any other method. A 1993 survey designed to validate these observations conclusively showed that electrophoresis-based assays are subject to a bias proportional to the total CK activity. These survey results were confirmed by studies with selected patients' specimens. We therefore conclude that electrophoresis-based assays may not warrant their reputation as the gold standard for CK isoenzyme measurement.


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A. R. Henderson, S. Krishnan, S. Webb, C. M. Cheung, D. J. Nazir, and H. Richardson
Proficiency testing of creatine kinase and creatine kinase-2: the experience of the Ontario Laboratory Proficiency Testing Program
Clin. Chem., January 1, 1998; 44(1): 124 - 133.
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