Lactate dehydrogenase activity is increased in plasma of infants with advanced necrotizing enterocolitis

Abstract

In infants with necrotizing enterocolitis (NEC), intestinal gangrene defines advanced disease. Since intestinal ischemia is considered a pathogenetic factor for intestinal gangrene, serum activity of mucosal and seromuscular enzymes may be elevated in these patients. Our aim was to evaluate if serum enzymes activity is increased in infants with NEC associated with intestinal gangrene. We performed a retrospective review of the case notes of infants operated on for NEC between 1998 and 2006. Patients with preoperative determination of serum enzymes were included in the study, and were divided into Group A and Group B based on the presence or absence of intestinal gangrene, respectively. Serum activities of alkaline phosphatase (ALP), glutamic oxaloacetic transaminase (GOT), creatine kinase (CK), and lactate dehydrogenase (LDH) were compared in the two Groups. Values are medians (interquartile range). Thirty-five infants were operated on for NEC in the study period. Eighteen patients fulfilled the inclusion criteria: 12 in Group A and six in Group B. Group A patients had significantly higher LDH activity [1131.0 (1092.0-1300.0) vs. 482.0 (440.0-624.5) IU/L; P < 0.005]. Our findings suggest that LDH activity may be increased in infants with NEC and intestinal gangrene. Its evaluation could be a further tool in the surgical decision making process in infants with NEC.

Plasma D-lactate Levels in Necrotizing Enterocolitis in Premature Infants

“…Once patients are diagnosed with definitive NEC (Bell’s stage 2), significant intestinal damage is likely to occur. Therefore, it is possible that earlier detection of intestinal injury and appropriate treatment might prevent the progression of the disease ( 7 , 8 ). Despite rapid modern medical advances, the etiology remains elusive, and morbidity and mortality is unacceptably high, with as much as 10% - 30% of affected infants succumbing to the disease ( 9 , 10 ).…”

Lactic Dehydrogenase in Umbilical Cord Blood in Healthy Infants after Different Modes of Delivery

“…In critically ill asphyxiated newborns, depending on the time of blood collection after the insult, the LDH values are 2 to 5-fold increase compared to the 97.5th percentile in the present study. The 97.5th percentile of approximately 612 U/L (10.2 ukat/L) cut-off seems to be clinically useful also in other conditions that cause illness in the neonatal period [21][22][23].…”

Urinary intestinal fatty acid–binding protein concentration predicts extent of disease in necrotizing enterocolitis

“…Although Bell et al [2] published staging criteria for NEC more than 20 years ago, which were subsequently modified by Walsh and Kliegman [3], and continue to see widespread use today, the diagnosis of NEC remains a challenge to neonatologists and surgeons. Accordingly, there has been interest in developing improved diagnostic tests for NEC [4][5][6][7][8][9].…”