The Utility of Elevated Serum Lactate Dehydrogenase in Current Clinical Practice

Lab Med. 2021 Mar 15;52(2):e17-e22. doi: 10.1093/labmed/lmaa059.

Abstract

Objective: Because of its wide tissue distribution, elevation of serum lactate dehydrogenase (LD) is a nonspecific finding. Although serum LD is still included in the prognosis and staging of metastatic melanoma and germ cell tumors, its nonspecificity has led to decreased usefulness.

Methods: In this study, we analyzed the serum LD assays performed in a 726-bed hospital during a 1-year period and reviewed charts of patients with serum LD of >3 standard deviations (SD).

Results: Of 312 patients with elevated serum LD, only 9 were patients with melanoma and germ cell tumors. The other 303 patients had other malignancies, chronic conditions, and sepsis.

Conclusion: Elevated serum LD (even >3 SD) is an extremely nonspecific finding that does not contribute to clinical management in a majority of patients. As such, serum LD testing should be retired from routine clinical order sets and restricted in use.

Keywords: LD; lactate dehydrogenase; serum LD; serum markers.

MeSH terms

  • Biomarkers / blood*
  • Humans
  • L-Lactate Dehydrogenase / blood*
  • Mass Screening* / standards
  • Mass Screening* / statistics & numerical data
  • Neoplasms / diagnosis
  • Neoplasms / epidemiology
  • Reference Values
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sepsis / diagnosis
  • Sepsis / epidemiology

Substances

  • Biomarkers
  • L-Lactate Dehydrogenase