BRAIN HYPOTHERMIA THERAPY FOR NEONATAL HYPOXIC-ISCHEMIC ENCEPHALOPATHY WITH A SEVERELY ELEVATED SERUM CREATINE KINASE LEVEL

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Several studies have shown that brain hypothermia therapy (BHT) after neonatal hypoxic-ischemic encephalopathy (HIE) can improve neurodevelopmental outcomes. However, there have been no reports of the neurodevelopmental outcomes for the infant with a serum creatine kinase (CK) level above 20,000 IU/L in association with neonatal HIE. We report a female infant with a very high serum CK level (26,428 IU/L) associated with neonatal asphyxia. We diagnosed this infant with moderate HIE, and BHT was achieved by head cooling within 6 hours after birth to an esophageal temperature of 34.5°C. There were no significant adverse events during BHT, and the CK level spontaneously decreased. Although we report only the short-term outcomes for this case, she presents neurodevelopmental delays at the age of 18 months. It may be correlated between high serum CK level and long-term neurodevelopmental delays.<br>Abbreviations: CK, creatine kinase; HIE, hypoxic-ischemic encephalopathy; BHT, brain hypothermia therapy; NRFS, non-reassuring fetal status; CK-MB, creatine kinase-myocardial band; MRI, magnetic resonance imaging; CK-BB, creatine kinase-brain band.

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