Approach to Asymptomatic HyperCKemia - EAN Guidelines

The provided text outlines the 2024 European Academy of Neurology (EAN) guidelines for diagnosing adults who exhibit elevated creatine kinase levels without significant symptoms. Because this condition can stem from non-neuromuscular factors like exercise and medication or hidden genetic disorders, the authors establish a standardized testing sequence to improve diagnostic accuracy. The experts advocate for a threshold of 1.5 times the upper limit of normal to trigger further investigation, beginning with repeated measurements and the exclusion of external causes. The protocol emphasizes modern, non-invasive techniques, specifically recommending Next Generation Sequencing (NGS) and muscle MRI as primary tools over traditional muscle biopsies. Additional specialized tests, such as Dried Blood Spots for Pompe disease and electromyography, are suggested to further refine the clinical picture. Ultimately, these guidelines aim to help clinicians efficiently identify underlying muscle or nerve diseases while avoiding unnecessary invasive procedures.