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Cellular source of serum lactate dehydrogenase elevation in patients with thrombotic thrombocytopenic purpura.

Publication ,  Journal Article
Cohen, JA; Brecher, ME; Bandarenko, N
Published in: J Clin Apher
1998

Elevated serum lactate dehydrogenase (LDH) is a characteristic finding in patients with thrombotic thrombocytopenic purpura (TTP). It is widely accepted that total serum LDH principally rises due to the release of red blood cell LDH as a consequence of intravascular hemolysis. To identify the cellular source of serum LDH in TTP, we prospectively analyzed total serum LDH and LDH isoenzyme profiles in 10 consecutive patients with classic, acute idiopathic TTP within 5 days of clinical presentation. Total LDH was quantitated on a Hitachi 911 Analyzer (Indianapolis, IN), using the lactate to pyruvate reaction. LDH isoenzymes were measured by serum protein electrophoresis, using the Beckman LDH Isoenzyme Kit (Anaheim, CA). Isoenzymes attributable to erythrocytes (LDH1, LDH2) were not disproportionately elevated in 9 of 10 patients. LDH3 was below or within normal limits for all 10 patients, and one patient showed a slightly increased LDH4. Serum LDH5, the isoenzyme derived primarily from liver and skeletal muscle, was elevated 1-2 times normal in all patients. Evidence supporting hemolysis as the major contribution to the elevated total serum LDH frequently encountered in acute TTP was not identified in this study. The isoenzyme fractions LDH and LDH2 elevated by erythrocyte injury were not disproportionately elevated in this series. LDH 5, the isoenzyme found in skeletal muscle and liver, was consistently 1- to 2-fold greater than normal in all patients. We propose that the elevation of serum LDH seen in patients with TTP is due to release of LDH from a variety of tissues damaged as a result of systemic ischemia.

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Published In

J Clin Apher

DOI

ISSN

0733-2459

Publication Date

1998

Volume

13

Issue

1

Start / End Page

16 / 19

Location

United States

Related Subject Headings

  • Purpura, Thrombotic Thrombocytopenic
  • Prospective Studies
  • L-Lactate Dehydrogenase
  • Isoenzymes
  • Humans
  • Erythrocytes
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences
 

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Cohen, J. A., Brecher, M. E., & Bandarenko, N. (1998). Cellular source of serum lactate dehydrogenase elevation in patients with thrombotic thrombocytopenic purpura. J Clin Apher, 13(1), 16–19. https://doi.org/10.1002/(sici)1098-1101(1998)13:1<16::aid-jca3>3.0.co;2-c
Cohen, J. A., M. E. Brecher, and N. Bandarenko. “Cellular source of serum lactate dehydrogenase elevation in patients with thrombotic thrombocytopenic purpura.J Clin Apher 13, no. 1 (1998): 16–19. https://doi.org/10.1002/(sici)1098-1101(1998)13:1<16::aid-jca3>3.0.co;2-c.
Cohen, J. A., et al. “Cellular source of serum lactate dehydrogenase elevation in patients with thrombotic thrombocytopenic purpura.J Clin Apher, vol. 13, no. 1, 1998, pp. 16–19. Pubmed, doi:10.1002/(sici)1098-1101(1998)13:1<16::aid-jca3>3.0.co;2-c.
Journal cover image

Published In

J Clin Apher

DOI

ISSN

0733-2459

Publication Date

1998

Volume

13

Issue

1

Start / End Page

16 / 19

Location

United States

Related Subject Headings

  • Purpura, Thrombotic Thrombocytopenic
  • Prospective Studies
  • L-Lactate Dehydrogenase
  • Isoenzymes
  • Humans
  • Erythrocytes
  • Cardiovascular System & Hematology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1103 Clinical Sciences