Urinary lactic dehydrogenase isoenzyme IV and V in the differential diagnosis of cystitis and pyelonephritis

Devaskar, Uday; Montgomery, W. F.

doi:10.1016/s0022-3476(78)81078-6

Cited by 21 publications

(6 citation statements)

References 5 publications

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“…Urinary LAD-5 may originate from renal tissue as a consequence of a number of pathological processes [10][11][12], or from leukocytes. It is often difficult to rule out the contribution of white blood cells to the urinary levels of LAD-5 in patients with UTI.…”

Section: -4]mentioning

confidence: 99%

Contribution of Four Markers of Tubular Proteinuria in Detecting Upper Urinary Tract Infections

Mengoli

Lechi

Arosio

et al. 1982

Nephron

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The presence of tubular involvement, as a marker for the detection of urinary tract infection (UTI) site, was examined in 19 patients with pyelonephritis and in 15 patients with cystitis or asymptomatic bacteriuria. The urinary excretion of four markers of tubular proteinuria, β₂-microglobulin (β₂M), lysozyme (LZ), lactic dehydrogenase isoenzyme V (LAD-5) and N-acetyl-βD-glucosaminidase (NAG), was investigated. LAD-5 appeared particularly valuable for the early detection of upper UTI. However, the overall diagnostic accuracy appeared to be further strengthened using, besides LAD-5, one additional variable. A set of simple and noninvasive biochemical tests on urine samples can reliably help to identify the site of UTI.

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Section: -4]mentioning

confidence: 99%

Contribution of Four Markers of Tubular Proteinuria in Detecting Upper Urinary Tract Infections

Mengoli

Lechi

Arosio

et al. 1982

Nephron

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“…In patients with a lower UTI, such as cystitis, the predominance of U-LDH1 and U-LDH2 is maintained as it is, without significant increase in total U-LDH activity [10]. Under conditions of an upper UTI, such as pyelonephritis, the isozyme composition changes from predominance of U-LDH1 and U-LDH2 (fast-zone pattern) to that of U-LDH4 and U-LDH5 (slow-zone pattern) [10, 11]. Since leukocytes contain abundant LDH4 and LDH5, the presence of elevated numbers of leukocytes in the urine may result in a shift to the predominance of U-LDH4 and U-LDH5 [9].…”

Section: Discussionmentioning

confidence: 99%

“…Since leukocytes contain abundant LDH4 and LDH5, the presence of elevated numbers of leukocytes in the urine may result in a shift to the predominance of U-LDH4 and U-LDH5 [9]. Furthermore, it has been reported that infection, ischemia, or necrosis can alter the isozyme composition of renal tissue [11]. …”

Section: Discussionmentioning

confidence: 99%

Urinary Lactate Dehydrogenase Activity and Its Isozyme Patterns in Kawasaki Disease

Kawamura

Takeshita

Kanai

et al. 2017

International Journal of Pediatrics

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Abnormal urinary findings, such as sterile pyuria, proteinuria, and microscopic hematuria, are often seen in the acute phase of Kawasaki disease (KD). We investigated the potential significance of urinary lactate dehydrogenase (U-LDH) activity and its isozyme patterns in KD. Total U-LDH activity and its isozymes (U-LDH1-5) levels were compared among 120 patients with KD, 18 patients with viral infection (VI), and 43 patients with upper urinary tract infection (UTI) and additionally compared between intravenous immunoglobulin (IVIG) responders (n = 89) and nonresponders (n = 31) with KD. Total U-LDH activity was higher in KD (35.4 ± 4.8 IU/L, P < 0.05) and UTI patients (66.0 ± 8.0 IU/L, P < 0.01) than in VI patients (17.0 ± 6.2 IU/L). In the isozyme pattern analysis, KD patients had high levels of U-LDH1 and U-LDH2, while UTI patients had high levels of U-LDH3, U-LDH4, and U-LDH5. Furthermore, IVIG nonresponders of KD had significantly higher levels of total U-LDH activity (45.1 ± 4.7 IU/L, P < 0.05), especially U-LDH1 and U-LDH2 (P < 0.05), than IVIG responders (32.0 ± 2.8 IU/L). KD patients have increased levels of total U-LDH activity, especially U-LDH-1 and U-LDH2, indicating a unique pattern of U-LDH isozymes different from that in UTI patients.

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“…Meanwhile, Gelderman et al (1965) reported that deviation towards the LDH M-fraction in the urine is due to the presence of increased leucocytes rather than the presence of tumour cells derived from bladder cancers. It has also been described that the determination of urinary LDH isoenzymes may be more useful in diagnosing the location of urinary tract infection rather than the presence of bladder neoplasias because LDH-5 is usually elevated in upper urinary tract infections (Fries et al, 1977;Devaskar et al, 1978;Lorentz et al, 1979). Experimentally, Cunningham et al (1977) have confirmed the increased level of urinary LDH-5 in the rat model of pyelonephritis.…”

Section: Discussionmentioning

confidence: 99%

“…Increased urinary LDH may reflect contamination of urine with cells such as polymorphonuclear leucocytes, or proteinuria rather than the presence of neoplasia (Mirabile et al, 1966;Malik et al, 1983). It has also been suggested that urinary LDH isoenzyme patterns vary according to the site of inflammation in the urinary tract (Devaskar & Montogomery, 1978). However, unless urine is heavily contaminated with inflammatory cells, the M-fraction of urinary LDH may increase with the rising stage and the grade of the bladder tumour (Mortomiya et al, 1975(Mortomiya et al, , 1979.…”

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confidence: 99%

The diagnostic significance of lactate dehydrogenase isoenzymes in urinary cytology

Nishikawa

Tanaka²,

Takeuchi³

et al. 1991

Br J Cancer

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Summary Lactate dehydrogenase (LDH) isoenzyme distribution was examined in 106 urine samples being tested cytologically for evidence of bladder cancer; the samples were selected to have <20 leucocytes and erythrocytes per high power field and the LDH pattern determined by electrophoresis. The Papanicolaou stained-smears showed 68 negative, 17 suspicious and 21 positive. The LDH M-fraction of the urinary supernatant in cytologically positive cases was significantly greater than in negative cases, although the latter included a few false negative samples. Some of the false negatives gave positive results for the LDH M-fraction; these results suggest that the determination of LDH isoenzymes in the urine is useful in diagnosing urinary tract cancers, including early stage, and for follow-up of patients with bladder cancers after surgical resection.Because of such advantages as the ease of sample collection, the ability to test frequently and the absence of risk to patients, urine cytology has been regarded as one of the most useful diagnostic procedures for the screening of urinary tract neoplasms as well as for their post-operative follow-up (Fujii et al., 1982 (Fujii et al., 1982).The presence of lactate dehydrogenase (LDH) activity in urine was initially reported by Rosalki and Wilkinson (1959). Although Wacker and Dorfman (1962) noted elevated levels of LDH activity in the urine of patients with carcinoma of the urinary tract, the elevation of total urinary LDH activity is not now assumed to be cancer specific (Posey & Morgan, 1977). Increased urinary LDH may reflect contamination of urine with cells such as polymorphonuclear leucocytes, or proteinuria rather than the presence of neoplasia (Mirabile et al., 1966;Malik et al., 1983). It has also been suggested that urinary LDH isoenzyme patterns vary according to the site of inflammation in the urinary tract (Devaskar & Montogomery, 1978). However, unless urine is heavily contaminated with inflammatory cells, the M-fraction of urinary LDH may increase with the rising stage and the grade of the bladder tumour (Mortomiya et al., 1975(Mortomiya et al., , 1979. Therefore, it has been emphasised that the combination of urinary cytology and the determination of urinary LDH isoenzymes may be of value in the diagnosis of bladder tumours (Motomiya et al., 1975(Motomiya et al., , 1979. In the present study, urinary LDH isoenzymes were evaluated in urinary specimens examined by routine cytology. Materials and methodsUrinary specimens collected from routine cytology were centrifuged at 1,500 r.p.m. for 10 min. The method. Simultaneously, air-dried smears were also prepared for Giemsa stain to determine the number of contaminating leucocytes and erythrocytes per high powered field (x 400). Cytological findings were interpreted as negative, suspicious or positive for malignant cells in the Papanicolaou-smears.Thus, a total of 106 specimens which contained less tjhan 20 leucocytes and less than 20 erythrocytes per high power field and were cytologically diagnosed as negative...

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Urinary lactic dehydrogenase isoenzyme IV and V in the differential diagnosis of cystitis and pyelonephritis

Cited by 21 publications

References 5 publications

Contribution of Four Markers of Tubular Proteinuria in Detecting Upper Urinary Tract Infections

Contribution of Four Markers of Tubular Proteinuria in Detecting Upper Urinary Tract Infections

Urinary Lactate Dehydrogenase Activity and Its Isozyme Patterns in Kawasaki Disease

The diagnostic significance of lactate dehydrogenase isoenzymes in urinary cytology

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