Many thanks to many colleagues who suggested
pernicious anaemia as a possible cause.
Intravascular haemolysis is unlikely with normal AST
of 18 IU/L and the blood film didn't show red cell
fragments. There is also no hypersegmented
neutrophils, only mild macrocytosis (MCV 103 fl) and
serum B12 was 187 pg/L (170 - 720). I have n't seen
such high LDH in PA before. Intrinsic factors Abs has
been sent away. Can we be certain that this PA from
these biochemical findings so far?
Mohammad
--- Bruce Muller <[log in to unmask]> wrote: > We had a
very similar case (but age 36) at Charing
> Cross recently, LDH
> = 15750 u/L, slightly raised AST, slightly raised
> bilirubin, Hb = 4.5,
> which proved to be PA (B12<60ng/ml). 1 month
> later, Hb = 13.3, B12 =
> 1372, LDH = 354.
>
> Bruce Muller
>
> >>> Mohammad Al-Jubouri <[log in to unmask]>
> 11/08/02 12:14pm >>>
> Dear All
>
> An elderly lady had a serum LDH of 12893 IU/L, all
> other tests including ALT, AST, CK, bilirubin, ALP
> and
> U/Es were normal. The serum sample had a brownish
> hue
> on inspection, not a normal serum look. The patient
> is
> anaemic (Hb 7.0 g/dL) and had mild thrombocytopaenia
> and leucopenia. Lymphomas usually produce less
> elevation of LDH (1000-2000 IU/L)!
>
> Any ideas about the source of this markedly raised
> LDH?
>
> Thanks
>
> Mohammad
>
>
> =====
> Dr. M A Al-Jubouri
> Consultant Chemical Pathologist
>
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