Diagnostic Serum Enzymes Aldolase: Aldolase is present most significantly in skeletal and heart muscle. Damage to skeletal muscle produces high serum levels of aldolase, particularly in the case of progressive muscular dystrophy. Aldolase may also be slightly increased in early stages of viral hepatitis and advanced cancer of the prostate. Creatine Phosphokinase (CPK or CK) : CPK catalyzes the reversible transfer of phosphate groups between creatine and phosphocreatine as well as between ATP and ADP. Most of the CPK resides in skeletal muscle, heart muscle, and in the gastrointestinal tract. CPK enters the blood rapidly following damage to muscle cells. At first CPK seemed to be an excellent marker for acute myocardial infarction (heart damage) or skeletal muscle damage. Unfortunately, the CPK levels rise and fall rapidly and coincide with a variety of other circumstances including surgical procedures, vigorous exercise, a fall, or a deep intramus
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