In many children additional tests included: serum creatine phosphokinase (CPK),
lactic dehydrogenase (LDH), ammonia and bilirubin; presence/titres of IgM class antibodies against a number of viruses (known to be associated with acute brain disease) and Leptospira species; blood, CSF and urine bacterial culture; viral isolation studies on serum, CSF, urine and visceral specimens.
Lactic dehydrogenase: a biochemical marker for preeclampsia-eclampsia.
Serum tumor markers were detected before operation and the results were as following: CA 125 34.20 U/ml, (normal range: 0–35.00 U/ml), CA 199 34.11 U/ml (normal range: 0–39.00 U/ml), alpha-fetoprotein (AFP) >1210.0 ng/ml (normal range: 0–7.0 ng/ml), beta-human chorionic gonadotropin ([sz]-hCG) 12.81 U/L (normal range: 0–2.90 U/L), and
lactic dehydrogenase (LDH) 204 U/L (normal range: 109–245 U/L).
Other test results (liver and renal function, serum folate and vitamin B12 levels,
lactic dehydrogenase levels, C-reactive protein, serum protein electrophoresis, direct and indirect Coombs tests, and antinuclear antibody tests) were within normal limits, as were viral serologic test results (HIV, hepatitis B virus, hepatitis C virus, parvovirus B19).
WORK-UP: His erythrocyte sedimentation rate was over 130 mm/h (normal range, 1-15 mm/h),
lactic dehydrogenase was 311 U/L (normal range, 118-273 U/L), and C-reactive protein was 21.8 mg/dL (normal range, 0-0.5 mg/dL).
The white blood cell count was 70,000 per [micro]L and the
lactic dehydrogenase level was 12 000 U/L.
The alkaline phosphatase (4.4 [mu]kat, 262 U/L),
lactic dehydrogenase (LDH) 7.55 [mu]kat, 453 U/L) and aspartate aminotransferase (AST) (88 U/L) were all elevated.
Blood sample was sent for serum amylase and
lactic dehydrogenase.
Laboratory studies showed an elevation of
lactic dehydrogenase (1,403 IU/L; normal 180-460 IU/L), ferritin (12,727.0 ng/mL; normal 4.0-64.2 ng/mL), and soluble interleukin-2 receptors (1,660 U/mL; normal 145-519 U/mL).
On the 11th day, he is transported to the pediatric ICU, where the following abnormalities are noted: metabolic acidosis with compensatory tachypnea; hyponatremia; increased creatine levels, total bilirubin levels, and
lactic dehydrogenase levels; decreased albumin levels; high triglyceride levels; and neutropenia with an absolute neutrophil count of 0.
(5,8,9,10) Additionally,
lactic dehydrogenase was consistently elevated with an average value of 5162.4 UI/L.
Nature and development of
lactic dehydrogenases. Science, 136: 962-969.