Lactic Acid Dehydrogenase (LD)

CPT: 83615
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Expected Turnaround Time

Within 1 day


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Specimen Requirements


Specimen

Serum (preferred) or plasma


Volume

1 mL


Minimum Volume

0.7 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube. Do not use oxalate, EDTA, or citrate plasma.


Collection

Separate serum or plasma from cells within 45 minutes of collection.


Storage Instructions

Maintain specimen at room temperature.1


Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

7 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Causes for Rejection

Plasma specimens collected in EDTA, oxalate, or citrated tubes; gross hemolysis; gross bacterial contamination; improper labeling


Test Details


Use

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, renal diseases, and cirrhosis. Mild increases in LDH activity have been reported in cases of myocardial or pulmonary infarction, leukemia, hemolytic anemia, and nonviral hepatitis.2


Limitations

Hemolysis elevates LDH results, oxalate inhibits LDH, and ascorbic acid can decrease LDH values.


Methodology

Enzymatic, colorimetric, UV


Reference Interval

See table.

Age

Male (IU/L)1

Female (IU/L)1

0 to 7 d

123−237

123−237

8 to 30 d

126−331

130−275

1 to 11 m

143−381

128−376

1 to 3 y

195−361

192−352

4 to 6 y

180−313

180−311

7 to 9 y

166−291

166−290

10 to 12 y

155−280

135−260

13 to 15 y

126−244

118−215

16 to 17 y

118−222

114−209

>17 y

121−224

119−226


Additional Information

In infectious mononucleosis, LD is usually more elevated than AST, and there is usually an isomorphic pattern of LD isoenzymes. In viral hepatitis, by contrast, AST and ALT (the transaminases) are much more increased than is LD, about three or more times higher than total LD, and LD5 is high. The differential diagnosis of acute infarct of myocardium includes pericarditis and angina, entities in which enzymes are usually not substantially increased. Bovine or porcine heparin therapy can cause increases of AST, ALT, and LD, with elevated LD hepatic fractions.2


Footnotes

1. LabCorp internal studies.
2. Tietz NW. Clinical Guide to Laboratory Tests. 4th ed. Philadelphia, Pa: WB Saunders Co; 2006.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001115 LDH 14804-9 001115 LDH IU/L 14804-9

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