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HelpTest ID LD Lactate Dehydrogenase (LDH), Serum
Reporting Name
Lactate Dehydrogenase (LD), SUseful For
Investigation of a variety of diseases involving the heart, liver, muscle, kidney, lung, and blood
Monitoring changes in tumor burden after chemotherapy; lactate dehydrogenase elevations in patients with cancer are too erratic to be of use in the diagnosis of cancer
Testing Algorithm
For more information see Multiple Myeloma: Laboratory Screening
Specimen Type
SerumNecessary Information
Patient's age is required.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Ambient (preferred) | 7 days | |
| Frozen | 30 days | ||
| Refrigerated | 48 hours |
Reference Values
1-30 days: 135-750 U/L
31 days-11 months: 180-435 U/L
1-3 years: 160-370 U/L
4-6 years: 145-345 U/L
7-9 years: 143-290 U/L
10-12 years: 120-293 U/L
13-15 years: 110-283 U/L
16-17 years: 105-233 U/L
≥18 years: 122-222 U/L
Day(s) Performed
Monday through Sunday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
83615
Clinical Information
Lactate dehydrogenase (LDH) activity is present in all cells of the body with highest concentrations in heart, liver, muscle, kidney, lung, and erythrocytes. Serum LDH is elevated in a number of clinical conditions.
Interpretation
Marked elevations in lactate dehydrogenase (LDH) activity can be observed in megaloblastic anemia, untreated pernicious anemia, Hodgkin disease, abdominal and lung cancers, severe shock, and hypoxia.
Moderate to slight increases in LDH levels are seen in myocardial infarction, pulmonary infarction, pulmonary embolism, leukemia, hemolytic anemia, infectious mononucleosis, progressive muscular dystrophy (especially in the early and middle stages of the disease), liver disease, and kidney disease.
In liver disease, elevations of LDH are not as great as the increases in aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
Increased levels of the enzyme are found in about one-third of patients with kidney disease, especially those with tubular necrosis or pyelonephritis. However, these elevations do not correlate well with proteinuria or other parameters of kidney disease.
On occasion a raised LDH level may be the only evidence to suggest the presence of a hidden pulmonary embolus.
Cautions
Red blood cells contain much more lactate dehydrogenase (LDH) than serum. A hemolyzed specimen is not acceptable. LDH activity is one of the most sensitive indicators of in vitro hemolysis. Causes can include transportation via pneumatic tube, vigorous mixing, or traumatic venipuncture.
While increases in serum LDH also are seen following a myocardial infarction, the test has been replaced by the determination of troponin.
Clinical Reference
Panteghini M, Bais R: Serum enzymes. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:407-431
Method Description
Lactate and nicotinamide adenine dinucleotide (NAD[+]), in the presence of lactate dehydrogenase (LD), are converted to pyruvate and NADH. The rate at which NADH is formed is determined by an increase in absorbance and is directly proportional to enzyme activity.(Package insert: LDH reagent. Roche Diagnostics; 08/2019)
Report Available
Same day/1 to 3 daysReject Due To
| Gross hemolysis | Reject |
NY State Approved
YesMethod Name
Photometric Rate Reaction