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VALUE OF ESTIMATION OF LDH (LACTIC DEHYDROGENASE) IN PRIVATE PRACTICE

OP Kapoor

Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

Often, LDH level in the blood is reported to be high. It is falsely positive because of wrong collection of the blood and subsequence haemolysis of the RBCs. However, there are a few conditions which a medical practitioner should know about, where very high values are present which help towards the diagnosis.

In my experience, I have been helped in the following diseases when this blood test was found positive.

1.In a "common fever" patient, if the LDH is markedly raised, the most likely cause is malaria.

2.In an anaemic patient, if the LDH is markedly raised, the most likely cause is megaloblastic anaemia and not iron deficiency anaemia.

3.In a patient who has glandular mass in the mediastinum, as seen on X-ray chest and CT scan, most of the times the differential diagnosis between Kochs, sarcoidosis, lymphomas, fungal diseases and connective tissue disorders cannot be made. If the LDH levels are very high, it is very much in favour of a lymphoma.

Finally, in any patient of malignancy anywhere in the body (diagnosed or undiagnosed) markedly raised levels of LDH and blood uric acid are in favour of advanced malignancy with extensive spread all over the body and secondary deposits.

ACKNOWLEDGEMENT

I am thankful to Dr. Sunil Parekh and Dr. Deepak Amarapurkar for sharing their experiences with me.


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