LACTIC DEHYDROGENASE ELEVATION

LACTIC DEHYDROGENASE ELEVATION: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. What is the level of creatine phosphokinase isoenzyme containing M and B subunits (MB-CPK) ? An elevated MB-CPK combined with elevated LDH is most likely due to a myocardial infarction, although myocarditis and pericarditis can produce a similar picture.
2. What is the AST level? If the MB-CPK or CPK are not also increased, an elevation of both the LDH and AST would point to liver disease.
3. What are the serum and urine creatine levels? If these are elevated, muscle disease must be considered likely.
4. What does the lung scan show? If positive, a lung scan separates pulmonary infarction from the other conditions in this group.

DIAGNOSTIC WORKUP

The diagnostic workup should include a CBC, urinalysis, chemistry panel, sedimentation rate, ANA, urine and serum creatine, urine myoglobin, serial EKGs, blood gas analysis, LDH isoenzymes, chest x-ray, lung scan, EMG, and cardiology and neurology consults. A liver scan, CT scan of the abdomen and liver, and muscle biopsy may be necessary.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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