Serum lactate dehydrogenase is a novel marker for the evaluation of disease severity in the early stage of toxic epidermal necrolysis

Abstract

Objective: To evaluate serum lactate dehydrogenase (LDH) and its correlation with skin manifestations in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

Methods: Serum LDH levels were measured in 33 patients (17 SJS and 16 TEN), from initial hospital admission to remission stage.

Results: The mean LDH level was 920.82 +/- 655.50 U/l in TEN and 595.35 +/- 182.03 U/l in SJS (normal range: 218-472). We arbitrarily divided these patients into 2 groups, the first were admitted within 3 days of onset (early stage) and the second after 4 days of onset (late stage). The ratio of early- to late-stage patients was 7:9 in TEN and 7:10 in SJS. The mean LDH level for 7 TEN patients in the early stage was 1,319.14 +/- 843.10 U/l, which was significantly higher than that of the SJS group (686.71 +/- 171.81 U/l; p = 0.024). In the late-stage patients, the mean levels of TEN and SJS patients were 611.0 +/- 160.33 and 531.4 +/- 167.89 U/l, respectively; these differences between TEN and SJS were not significant.

Conclusion: Serum LDH levels can be used as a marker of disease severity in the early stage of TEN.