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Lactate Dehydrogenase LDH

Also known as: LDH
This test is ordered by the doctor to help in detecting conditions causing tissue damage like blood or liver disease. It also aids in monitoring the progress of damage, to help stage or determine prognosis, to help elevate body fluid, and to identify response to treatment of certain kinds of cancers.
The test is ordered alongside other tests usually. The doctor orders it when he or she suspects that you may have a chronic or acute condition that is leading to tissue damage or causing the destruction of cells. It may also be ordered if you are someone who has been diagnosed with cancer, is showing signs of meningitis, or has fluid accumulation in specific parts of your body.
There are different kinds of samples that can be drawn for the test. In some cases, a blood sample is drawn by inserting a needle into the vein of the arm. Sometimes, body fluid may need to be collected, so special procedures may be performed to obtain fluid from the body, such as using a spinal tap to obtain cerebrospinal fluid from the body. Other types of fluids may also be collected, like peritoneal fluid or pleural fluid.
There is no special preparation needed for the test.
Lactate dehydrogenase is an enzyme that is a critical component in energy production. It is prevalent in all of the body’s cells, with higher concentrations in the heart, liver, muscles, lungs, kidneys, and blood cells. This test examines the levels of the enzyme in the blood and other fluids. LD is present in the blood in small amounts. It is released from the cells into the serum of the blood when cells are destroyed. LD in the blood is a nonspecific marker of tissue damage in the body. However, it can not be used by itself to identify the root cause of damage. It can be used in conjunction with other blood tests to evaluate and monitor conditions that lead to damage to the tissues. LD is also found in the fluid where there is injury, inflammation, and infection(Septicemia). The level of LD present in the fluid helps in determining the cause of the condition. It also aids in determining if fluid accumulation in the heart or the lungs is due to injury, also known as exudate, or due to an imbalance of fluid pressure in the blood vessels and the protein level in the blood – also known as transudate.
This test is a non-specific test that may be used in the assessment of a variety of diseases and conditions. A lactate dehydrogenase blood test is used:
 
  1. As a general indicator of the existence and severity of acute or chronic tissue damage
  2. In order to identify and evaluate conditions that develop over time, like anemia, including hemolytic anemia and megaloblastic anemia, or severe infections
  3. In order to aid in staging and determining prognosis and/or monitoring treatment (i.e., chemotherapy) of cancers, such as germ cell tumors (e.g., some types of testicular cancer and ovarian cancer), lymphoma, leukemia, melanoma, and neuroblastoma
A lactate dehydrogenase test is performed on body fluids for varying reasons, such as:
 
  1. Helping in evaluating cerebrospinal fluid and distinguishing between bacterial or viral meningitis
  2. In order to evaluate body fluids from other parts of the body such as pleural, peritoneal, or pericardial fluid. The test helps in determining the root cause of the accumulation of the fluid – whether it is due to injury and inflammation or due to an imbalance of pressure within blood vessels and the amount of protein in the blood. This information aids in charting out treatment plans.
Different types of LDH tests are ordered for different reasons.
 
  • Blood test:
When the doctor suspects that a disease or condition is causing some degree of cellular or tissue damage, he or she may order the LD test as part of the comprehensive metabolic panel. If the results show that LD is elevated, then the doctor may order more specific tests, such as ALT, AST, or ALP. These may help diagnose the condition and determine exactly which organs are involved. Once the doctor diagnoses the acute or chronic problem, he or she may order total LD levels at regular intervals to monitor its progress and/or resolution. In addition, the doctor may order LD levels when the patient has undergone muscle trauma or injury or when he or she has signs and symptoms of hemolytic anemia. LD testing may also be ordered on a regular basis when an individual has been diagnosed with cancer.
 
  • Body fluid test:
The doctor orders this test in a situation where a patient has signs and symptoms of meningitis or when someone has a build-up of fluid around the heart, lungs, or abdomen.
Different tests indicate different conditions.
 
  • In terms of a blood test:
Higher levels of LD point towards some kind of tissue damage. LD levels usually rise when cellular destruction begins. They peak sometime after and then begin to decrease. LD levels tend to be high in a number of different conditions: A higher level of LD is linked with
 
  1. Hemolytic anemia
  2. Pernicious anemia (megaloblastic anemia)
  3. Infections such as infectious mononucleosis (mono), meningitis, encephalitis, HIV
  4. Sepsis
  5. Intestinal, myocardial (heart), and lung (pulmonary) infarction
  6. Acute kidney disease
  7. Acute liver disease
  8. Acute muscle injury
  9. Pancreatitis
  10. Bone fractures
  11. Testicular cancer, lymphoma, or other cancers
  12. Severe shock
  13. Lack of oxygen (hypoxia)
An increased LD level in the blood may indicate that treatment for cancer (e.g., chemotherapy) has not been successful. Increased LD in the blood paints a bleak outlook for survival for those with cancer. In some chronic and progressive conditions, moderately elevated LD blood levels are detectable. Low and normal levels of LD are not linked to issues. Sometimes low levels are seen when someone ingests large amounts of ascorbic acid (vitamin C).
 
  • Body fluids:
Cerebrospinal fluid—a high LD suggests that meningitis is likely caused by bacteria, while a low or average level shows that viral meningitis is more likely. A high LD indicates that pericardial fluid, peritoneal or pleural fluid is an exudate, while a low level indicates it is transudate. Transudates are usually caused by congestive heart failure or cirrhosis.
 
Related Tests: Comprehensive Metabolic Panel (CMP), Haptoglobin, Liver Panel (LFT), Cerebrospinal Fluid (CSF) Testing, Body Fluid Testing, Pleural Fluid Testing, Pericardial Fluid Analysis, Peritoneal Fluid Analysis, Tumor Markers
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