Abstract
The enzyme lactate dehydrogenase (LDH) is found in metabolically active cells, especially heart, liver, brain, skeletal muscles, kidneys,
and blood. During metabolism, enzymes are released into the bloodstream at a constant rate. Serum LDH can be subdivided into five primary isoenzymes,
LDH1 through LDH5, by electrophoresis.2
When tissues are damaged, serum LDH rises due to cellular leakage, and the resultant isoenzyme patterns reflect isoenzymes found in the
affected tissue.2-6,8
Serum LDH isoenzyme activity was analyzed in cetaceans. Different clinical conditions such as intramuscular injection, azole therapy, and
apparent trauma produced distinctly different LDH isoenzyme profiles in cetaceans. A fourth distinctive pattern was occasionally observed in clinically normal
animals with elevations in transaminase and LDH activities. LDH isoenzyme activity patterns were not affected by mild or moderate hemolysis, refrigeration over 24
hours or freezing for 24 hours with subsequent thawing. However, severe hemolysis produced artifactual changes similar to those observed in individuals who
received injections, but of a lesser magnitude. LDH isoenzyme activity patterns may provide useful corroboration of other clinical findings when diagnostic
modalities are limited, especially to differentiate non-specific enzyme elevation from non-pathologic elevations in serum enzyme concentrations due to
intramuscular injections or azole therapy.
Clinical condition |
LDH1 |
LDH2 |
LDH3 |
LDH4 |
LDH5 |
Gross/hemolysis |
0a |
sl. |
0 |
sl. |
sl. |
IM injection |
0/ |
|
|
0/ |
|
Azole therapy |
0 |
0 |
0 |
0/ |
0 |
Apparent trauma |
|
|
|
|
|
Transient enzyme |
|
|
0 |
|
|
a. no change
References
1. Drent M, NA Cobben, RF Henderson, EF Wouters, M van Dieijen-Visser. 1996. The usefulness of lactate dehydrogenase and its
isoenzymes as indicators of lung damage or inflammation. Eur. Respir. J. 9:1736-1742.
2. Levinson SS, GA Hobbs. 1994. Usefulness of various lactate dehydrogenase isoenzyme-1 profiles after myocardial infarction.
Ann. Clin. Lab. Sci. 24:364-370.
3. Lossos IS, R Breuer, O Intrator, M Sonenblick. 1997. Differential diagnosis of pleural effusion by lactate dehydrogenase
isoenzyme analysis. Chest 111: 648-651.
4. Patel PS, SG Adhvaryu, DB Balar. 1994. Serum lactate dehydrogenase and its isoenzymes in leukemia patients: possible role in the
diagnosis and treatment monitoring. Neoplasm 41:55-59.
5. Sanchez Navarro MR, C Oliver Almendros, M Pena Caballero, JA Hurtado, M Samaniego Munoz. 1996. Lactate dehydrogenase isoenzymes
in the serum and bronchial aspirate of newborn infants with respiratory difficulty of different etiologies. An. Esp. Pediatr. 45:62-66.
6. Tilkian SM, MV Conover, AG Tilkian. 1983. Clinical Implication of Laboratory Tests, 3rd ed. C.V. Mosby Co, St. Louis,
Missouri. Pp. 107-131.
7. van Krugten M, NA Cobben, RJ Lamers, MP van Dieijen-Visser, SS Wagenaar, EF Wouters, M Drent. 1996. Serum LDH: a marker of
disease activity and its response to therapy in idiopathic pulmonary fibrosis. Neth. J. Med. 48:220-223.
8. Widmann FK. 1983. Clinical interpretation of laboratory tests. 9th ed. F.A. Davis Co., Philadelphia, Pennsylvania. Pp.
216-220.