The Clinical Implications of Spinal-Fluid Lactic Dehydrogenase Activity

Wróblewski, Felix; Decker, Barry; Wróblewski, Rita

doi:10.1056/nejm195803272581303

Cited by 61 publications

(16 citation statements)

References 2 publications

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“…The most consistent finding in this setting is an elevation of the LD isoenzyme-5 (LD-5) and an alteration of the LD-1:LD-5 ratio (5,8,10). Abnormal elevation of LD has also been described in patients with primary malignant brain tumors ( 1 1-18), cerebral infarction (7,12,14,15), infections (7,10,(19)(20)(21)(22)(23)(24)(25), neonatal hypoxia (26), and acute brain injury (7,12,27). This study covers a broad spectrum of various diseases, with four cases presented to illustrate the LD isoenzyme patterns under some special situations.…”

Section: Introductionmentioning

confidence: 96%

Diagnostic value of lactate dehydrogenase isoenzymes in cerebrospinal fluid

Chatterley¹,

Sun²,

Lien³

1991

Clinical Laboratory Analysis

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To evaluate the diagnostic value of lactate dehydrogenase (LD) isoenzymes in cerebrospinal fluid (CSF), 93 consecutive CSF specimens were analyzed. These specimens were from patients of four categories: tumors, infections, hemorrhages, and others. It was found that the isoenzyme patterns overlapped among different categories, but they differed within each category and were thus helpful in differential diagnosis. For instance, metastatic tumors showed prominent LD-5, whereas a primary brain tumor demonstrated an increase in all fractions. Viral encephalitis revealed an increase in the first three isoenzymes and bacterial meningitis, the last two. In acquired immune deficiency syndrome (AIDS) cases, however, LD isoenzyme changes were demonstrated in CSF when only cryptococcal meningitis and not when encephalitis was present. Both subdural and subarachnoid hemorrhages showed elevation of all fractions in our study. Elevation of the first three fractions was usually due to brain tissue damage or hemorrhage, as proven by our isoenzyme study of hemolysate mixed with CSF. The prominence of the last two fractions was related to anaerobic metabolism in the central nervous system or to granulocytic infiltration. In conclusion, LD isoenzyme analysis in CSF is helpful in differential diagnosis of various CNS disorders, although its sensitivity awaits further improvement.

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Section: Introductionmentioning

confidence: 96%

Diagnostic value of lactate dehydrogenase isoenzymes in cerebrospinal fluid

Chatterley¹,

Sun²,

Lien³

1991

Clinical Laboratory Analysis

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“…Based upon 1949 patients we found a reference range from 0-26 U/1. 8 The mean CSF LDH levels of the control subjects were 10-2 U/l with a standard deviation of 0 63 units. In this group statistical analyses were carried out to detect relationships between CSF LDH activities and age or sex.…”

Section: Resultsmentioning

confidence: 86%

Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours.

Twijnstra¹,

Zanten²,

Hart³

et al. 1987

Journal of Neurology, Neurosurgery & Psychiatry

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In this paper we discuss the change in the lactate dehydrogenase enzyme (LDH) activity in the CSF, found in patients with metastatic and non metastatic diseases of the CNS. The choice to study the CSF LDH enzyme is related to the fact that LDH belongs to routine laboratory determinations and with modern equipment, the catalytic activity of LDH in the CSF can be measured rapidly, precisely and economically.LDH is an enzyme that catalyses the final step in the metabolic chain of anaerobic glycolysis. Its molecular weight is 135,000 Daltons and it is predominantly located intracellular. LDH is a normal constituent of brain tissue and low activity can be measured in normal CSF. CSF LDH activity may increase in a number of conditions. Diagnostic significance has been ascribed to elevations of CSF LDH activities in cases of cerebrovascular diseases,5 bacterial mengingitis,-" head injury,6 primary brain tumours,7 1112 and CNS metastases from 313

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“…In der Literatur Hegen viele z. T. widersprechende Berichte über Liquorenzyme bei Tumoren vor [2,5,10,12,13,15,16,17,19,35,36,37]. Green et al [13] …”

Section: Tumorenunclassified

Die diagnostische Bedeutung der Glutamat-Oxalacetat-Transaminase, der Glutamat-Pyruvat-Transaminase, der Lactat-Dehydrogenase und der Sorbit-Dehydrogenase des Liquors im Kindesalter

Verrey¹

1962

Enzymol Biol Clin

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1. Bei 350 Kindern wurde die Glutamat-Oxalacetat-Trans- aminase, die Lactat-Dehydrogenase und bei einem Teil dieser Kinder auch die Py- ruvat-Transaminase und die Sorbit-Dehydrogenase im Liquor untersucht. Die Glu- tamat-Pyruvat-Transaminase und die Sorbit-Dehydrogenase zeigten keine diagnostisch verwendbaren Möglichkeiten. 2. Bei der idiopathischen Epilepsie sind die Liquorenzyme immer normal. 3. Bei unbehandelten bakteriellen Meningitiden betrug die Lactat-Dehydrogenase stets über 30 IU, bei der serösen und der tuberkulösen Meningitis waren die Werte normal. Da die Diagnose der tuberkulösen Meningitis häufig schwierig ist, kann die Bestimmung der Liquorenzyme in diesen Fällen von Nutzen sein. 4. Bei den Encephalitiden ist die Glutamat-Oxalacetat-Transaminase meist pathologisch, wobei die Höhe des Anstiegs mit der Schwere des klinischen Bildes einhergeht. Hier ist die Bestimmung des Enzyms für den Verlauf der Erkrankung von Bedeutung wie auch für die Prognose. 5. Bei progressiven Hirnleiden, besonders bei Lipidosen, sind sowohl Glutamat- Oxalacetat-Transaminase wie Lactat-Dehydrogenase erhöht. In stationären Phasen der Krankheit sind sie meist normal.

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The Clinical Implications of Spinal-Fluid Lactic Dehydrogenase Activity

Cited by 61 publications

References 2 publications

Diagnostic value of lactate dehydrogenase isoenzymes in cerebrospinal fluid

Diagnostic value of lactate dehydrogenase isoenzymes in cerebrospinal fluid

Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours.

Die diagnostische Bedeutung der Glutamat-Oxalacetat-Transaminase, der Glutamat-Pyruvat-Transaminase, der Lactat-Dehydrogenase und der Sorbit-Dehydrogenase des Liquors im Kindesalter

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