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Lactate Dehydrogenase: pathophysiologic marker

Lactate Dehydrogenase: pathophysiologic marker. Sara Pape-Salmon NP(F) Mental Health and Addictions Service, VIHA. What is Lactate Dehydrogenase?. Lactate Dehydrogenase (LDH) Intracellular enzyme Found in the cells of many body tissues:

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Lactate Dehydrogenase: pathophysiologic marker

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  1. Lactate Dehydrogenase: pathophysiologic marker Sara Pape-Salmon NP(F) Mental Health and Addictions Service, VIHA

  2. What is Lactate Dehydrogenase? • Lactate Dehydrogenase (LDH) • Intracellular enzyme • Found in the cells of many body tissues: • Heart, liver, RBC, kidneys, skeletal muscle brain, and lungs. • When these cells become injured, they lyse & LDH enters the blood stream.

  3. LDH Fractions: • LDH - although nearly ubiquitous body distribution, five separate fractions exist: • LDH 1 • LDH 2 • LDH 3 • LDH 4 • LDH 5

  4. LDH Tissue Distribution: • LDH - Total LDH • LDH 1 - Found in HEART predominantly • LDH 2 - RETICULOENDOTHELIAL system • LDH 3 - LUNGS (predominantly) • LDH 4 - KIDNEY, PLACENTA, PANCREAS • LDH 5 - mainly LIVER and STRIATED MUSCLE

  5. LDH & certain diseases: • LDH 1 - indicates MI (> LDH 2). Testicular tumors. • LDH 2 & 3 - Pulmonary disease: CHF, embolism, infarct, pneumonia, lymphoma & other reticuloendothelial tumors. AIDS - histoplasmosis. • LDH 4 - Pancreatitis, kidney disease • LDH 5 - liver disease (hepatitis, cirrhosis, neoplasm) ischemic bowel disease, striated muscle disease (muscular dystrophy, strenuous exercise)

  6. Should we be ordering LDH? • Although certain LDH patterns are classic for certain diseases, it is non-specific. • There are other tests/enzymes that are more specific • Can it be an important adjunct - yes…? • e.g. declining transaminases in context of liver disease • e.g. differentiating angina from heart attack • e.g. differentiate hepatic disease from benign condition (Gilbert’s disease vs. hemolytic disease)

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