Lactate Dehydrogenase (LD), Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Lactate dehydrogenase (LD) activity is present in all cells of the body with highest concentrations in heart, liver, muscle, kidney, lung, and erythrocytes. Serum LD is elevated in a number of clinical conditions.
Investigation of a variety of diseases involving the heart, liver, muscle, kidney, lung, and blood
Monitoring changes in tumor burden after chemotherapy, although, lactate dehydrogenase elevations in patients with cancer are too erratic to be of use in the diagnosis of cancer
Marked elevations in lactate dehydrogenase (LD) activity can be observed in megaloblastic anemia, untreated pernicious anemia, Hodgkin's disease, abdominal and lung cancers, severe shock, and hypoxia.
Moderate to slight increases in LD levels are seen in myocardial infarction (MI), pulmonary infarction, pulmonary embolism, leukemia, hemolytic anemia, infectious mononucleosis, progressive muscular dystrophy (especially in the early and middle stages of the disease), liver disease, and renal disease.
In liver disease, elevations of LD are not as great as the increases in aspartate amino transferase (AST) and alanine aminotransferase (ALT).
Increased levels of the enzyme are found in about one third of patients with renal disease, especially those with tubular necrosis or pyelonephritis. However, these elevations do not correlate well with proteinuria or other parameters of renal disease.
On occasion a raised LD level may be the only evidence to suggest the presence of a hidden pulmonary embolus.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Red blood cells contain much more lactate dehydrogenase (LD) than serum. A hemolyzed specimen is not acceptable. LD activity is 1 of the most sensitive indicators of in vitro hemolysis. Causes can include transportation via pneumatic tube, vigorous mixing, or traumatic venipuncture.
While increases in serum LD also are seen following a myocardial infarction, the test has been replaced by the determination of troponin.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
1-30 days: 135-750 U/L
31 days-11 months: 180-435 U/L
1-3 years: 160-370 U/L
4-6 years: 145-345 U/L
7-9 years: 143-290 U/L
10-12 years: 120-293 U/L
13-15 years: 110-283 U/L
16-17 years: 105-233 U/L
> or =18 years: 122-222 U/L
Clinical References Provides recommendations for further in-depth reading of a clinical nature
Tietz Textbook of Clinical Chemistry. 4th edition. Edited by CA Burtis, ER Ashwood, DE Bruns. Philadelphia, WB Saunders Company, 2006, pp 601-603