Lactate dehydrogenase and hemolysis in sickle cell disease.

摘要

Dr B alias has provided a thoughtful perspective on the meaning of elevated serum lactate dehydrogenase (LDH) in sickle cell disease. He is clearly correct that serum LDH is generally high at steady state in sickle cell disease and conies from multiple sources, representing damage to cells from several different organs, but this is not the entire story. There are several lines of published data that address the questions he raises concerning the relationship of serum LDH to lysis of red cells. Our publication in Blood 7 years ago clearly documented the LDH isoenzyme data he requests. It showed at steady state an average of 71% of total LDH was derived from a combination of LD1 and LD2, reflecting disproportionate elevation of isoenzymes that are consistent with red cell origin.2 In fact, 96% of the specimens had LD1 levels above the expected range; isoforms of liver, muscle, lymphocytes, and platelets were un-derrepresented in total LDH.