VALUE OF ESTIMATION OF LDH
(LACTIC DEHYDROGENASE) IN PRIVATE PRACTICE
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.
I am thankful to Dr. Sunil Parekh and Dr. Deepak Amarapurkar for sharing their
experiences with me.