DAVID W. THOMAS, M.D.; SAUL W. ROSEN, Ph.D., M.D., F.A.C.P.; C. RONALD KAHN, M.D.; ROBERT TEMPLE, M.D.; NICHOLAS M. PAPADOPOULOS, Ph.D.
Increased serum lactate dehydrogenase activity (LDH) in a 62-year-old woman, found on routine screening, that persisted for 3 years has been investigated. Gel chromatography showed 99% of the LDH was in a form larger than normal; the remaining 1%, as well as the LDH in saliva and duodenal fluid, was apparently of normal molecular size. Serum protein studies showed increased immunoglobulin A (IgA) concentration, predominantly of the kappa light chain type. Immunoelectrophoretic and immunoprecipitation studies showed that nearly all the LDH was associated with the IgA. Lactic dehydrogenase isoenzyme separation showed an additional band between the normal third and fourth isoenzyme bands, corresponding to the region of IgA migration. The persistently high serum LDH activity may reflect slower clearance of the IgA-bound LDH. Macromolecular LDH must be included in the differential diagnosis of increased serum LDH.
THOMAS DW, ROSEN SW, KAHN CR, et al. Macromolecular Lactic Acid Dehydrogenase: A Cause of Increased Serum Lactate Dehydrogenase Activity. Ann Intern Med. 1974;81:434–439. doi: 10.7326/0003-4819-81-4-434
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Published: Ann Intern Med. 1974;81(4):434-439.
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