Pathology Handbook

LDH

Synonyms

LDH

Clinical Indications

Serum LDH is increased in many malignancies.  Mild to moderate increases probably reflect tissue destruction but very high levels (>2,000 IU/L) may be seen in patients with lymphoma or leukaemia and in certain cancers of ovary or testis. Some solid tumours (e.g. lung, colon, stomach) may occasionally produce very high levels of LDH. 

The test should has no role in the diagnosis of myocardial infarction

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Availability

On request if specific criteria met.

Specific Criteria

Monitoring of therapy in lymphoma or leukaemia as a marker of cell proliferation. LDH may also be used as a marker is some cases of ovarian and testicular germ cell tumours and assessment of melanoma and renal cell carcinoma. 

Turnaround Time

Daily

Specimen

Serum

Volume

1 ml

Container

Vacutainer gold top

Collection

Haemolysis will artefactually increase levels.

Causes for Rejection

Unlabelled or incorrectly labelled sample; not meeting specific criteria for analysis; haemolysed sample. Result supressed when haemolysis index > 60

Reference Range

240 - 480 U/L

Note that different laboratories use different methods for measuring LDH and results are NOT transferable between laboratories.

Interpretation

In patients on chemotherapy who are receiving granulocyte colony stimulating factor, LDH levels may increase in parallel with white cell count and should not be taken as evidence of worsening malignancy.
Increased levels of LDH may occur in a number of benign conditions including skeletal muscle disease, myocardial infarction, pernicious anaemia, thalassaemia and pulmonary embolism.