Diagnostic significance and source of lactate dehydrogenase and its isoenzymes in cerebrospinal fluid of children with a variety of neurological disorders.

Abstract

Two hundred and thirty-four cerebrospinal fluid (CSF) specimens from 183 different children were analysed for total lactate dehydrogenase (LD) activity and LD isoenzyme distribution. The LD activities were elevated in the CSF of patients with meningitis, especially with bacterial infections, and with central nervous system (CNS) leukaemia. The CSF LD isoenzyme patterns of both groups generally reflected the number and distribution of lymphocytes and granulocytes in the CSF. Increases in CSF LD levels also occurred in patients with other neurological disorders, such as hydrocephalus, raised intracranial pressure, and epileptic seizures. However, no significant increases in CSF LD activity nor abnormality of the isoenzyme distribution were noted in children who had had a non-specific febrile convulsion.

Role of CSF CK, LDH, GGTP Enzyme Levels in Diagnostic and Prognostic Evaluation of Meningitis

“…The LDH activity in CSF in PM is significantly higher (p <0.005) than in TBM. The LDH isoenzyme studies carried out in cases of bacterial meningitis have shown that the isoenzyme pattern is primarily a reflection of the presence or absence of leukocytes, and of the predominant type of cell present [18]. Although the number of cases studied in our case was relatively small, it is believed that it has significant value in diagnosis of early meningitis.…”

Lactic dehydrogenase isoenzyme in cerebrospinal fluid of children with febrile convulsions

“…The CSF total LDH and its isoenzymes LDH-1, LDH-2 and LDH-3 apparently originate from brain tissue, which contains the same isoenzymes (2,5,10). All levels increase when brain tissue is damaged as a result of non-infectious neurological disorders such as hydrocephalus, brain tumours and epilepsy.…”

“…Nelson et al (5) described the LDH activity in the CSF with non-specific febrile convulsions. However, there are no published analyses of LDH isoenzymes in febrile seizures.…”

Lactic Dehydrogenase Isoenzyme in Cerebrospinal Fluid of Children with Infantile Spasms

“…These include: bacterial meningitis (increase in LDH-4 and LDH-5); viral meningitis (increase in LDH-1 and LDH-2); intracranial tumors (LDH-5): cerebral hemorrhage (LDH-3, LDH-4, and LDH-5); leukemic and lymphomatous infiltration (LDH-3 and LDH-4); tuberculous meningitis (LDH-3); hydrocephalus (LDH-2 and LDH-3), and Guillain-Barré syndrome (LDH-3) [8, 9, 10, 11]. Some authors have suggested a disturbance in the blood-brain barrier which enables plasma LDH to reach the CSF, or alternatively, LDH production by neoplastic tissue or white blood cells and exogenous bacterial sources [4, 8, 12, 13, 14]. However, neither hypothesis has yet been proven.…”

“…Theories include a dysfunction of the monoaminergic neurotransmitter system in the brain stem and an abnormality of the immune system [1, 2]. CSF LDH and its typical isoenzymes, LDH-1, LDH-2, and LDH-3, apparently originate from the brain tissue which contains the same isoenzymes [13, 14]. Damage to the brain tissue in neurological non-infectious situations such as epilepsy or brain tumor causes an elevation in the total CSF LDH and the brain tissue isoenzymes, LDH-1 to LDH-3 [14].…”