What causes elevated lactate dehydrogenase isoenzymes?

May 16, 2023 Source: Cainiu Health

Dr. Yang Shuwen

Introduction

Elevated lactate dehydrogenase isoenzymes are generally caused by inflammatory lesions in the myocardium, which can affect the heart's normal contraction and relaxation, leading to the release of certain cellular enzymes into the bloodstream and resulting in increased isoenzyme levels. Liver damage or inflammatory lesions can impair liver function. Severe damage to red blood cells may also occur, exceeding the bone marrow's capacity for hematopoiesis.

Elevated levels of lactate dehydrogenase isoenzymes are generally caused by conditions such as myocarditis, hepatitis, and hemolytic anemia. A detailed analysis is as follows:

1. Myocarditis

Inflammation of the heart muscle can impair normal cardiac contraction and relaxation. When myocardial function is compromised, some cellular enzymes are released into the bloodstream, leading to increased isoenzyme levels. This elevation can help assess the extent of myocardial damage. Medications such as furosemide tablets or dopamine hydrochloride for injection may be used under a doctor's guidance to improve symptoms.

2. Hepatitis

Lactate dehydrogenase isoenzymes are primarily distributed in the liver and kidneys. Liver damage or inflammatory lesions can impair liver function, resulting in abnormal enzyme levels. To address liver dysfunction, medications such as reduced glutathione tablets or diammonium glycyrrhizinate capsules may be prescribed under medical supervision.

3. Hemolytic Anemia

Isoenzymes are also present in human red blood cells. Severe red blood cell destruction that exceeds the bone marrow’s ability to produce new cells can lead to abnormal test results, indicating an underlying disease. Medications such as prednisolone tablets or entecavir tablets may be used as directed by a physician to control disease progression.

In addition to the common causes listed above, elevated levels may also result from other conditions such as myocardial infarction or teratoma. It is recommended to undergo appropriate diagnostic tests to confirm the underlying cause.

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Lactate dehydrogenase 285 U/L

The commonly used clinical reference range for lactate dehydrogenase (LDH) is 109–245 U/L, with no significant differences observed across different age groups and populations. Generally, an LDH level of 285 U/L is considered elevated and may be caused by cell destruction and lysis, liver disease, acute myocardial infarction, hematological disorders, or tumors. Further diagnostic evaluation is required, followed by targeted treatment.

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How to interpret a complete biochemical test report

Under normal circumstances, a comprehensive biochemical test report should include indicators such as fasting blood glucose, alanine aminotransferase (ALT), creatinine, lactate dehydrogenase (LDH), and triglycerides. Fasting blood glucose is a key indicator for assessing blood sugar levels, typically defined as the blood glucose level after at least 8 hours without consuming any caloric intake. The normal range for fasting blood glucose is 4.4–6.1 mmol/L.