Elevated serum levels of LDH have been observed in a variety of disease states. The highest levels are seen in patients with megaloblastic anemia, disseminated carcinoma and shock. Moderate increases occur in muscular disorders, nephrotic syndrome and cirrhosis. Mild increases in LDH activity have been reported in cases of myocardial or pulmonary infarction, leukemia, hemolytic anaemia and non-viral hepatitis.
LDH is not available on haemolysed samples. Isoforms LDH-4 and LDH-5 (commonly raised in hepatopathy, diseases of skeletal muscle, malignant tumours) are not stable once refrigerated, and as such LDH requests added to samples stored refrigerated may give a falsely low result.
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