Lactate Dehydrogenase

Single-analyte tests

• Lactic Acid Dehydrogenase (LD) 001115

  Serum · Fasting not stated · Turnaround Within 1 day

  Method and collection

  Method

  Enzymatic, colorimetric, UV

  Collection

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

  Reference notes

  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

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Panels that include this biomarker

• COVID-19 Induced Thrombotic Microangiopathy Profile 164044

  6 analytes · Serum · Fasting not stated · Turnaround 2 - 4 days

  Method and collection

  Method

  See individual test components.

  Collection

  Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells. Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze plasma within four hours of blood collection and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit seperate frozen specimens for each test requested.

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• Lactate Dehydrogenase (LD) Isoenzymes 001842

  6 analytes · Serum · Fasting not stated · Turnaround 3 - 6 days

  Method and collection

  Method

  Electrophoresis

  Preparation

  Cardiac enzymes and isoenzymes are best interpreted as a sequential series. Typically, a series of three: one at admission (or initial event) and two more at six- to eight-hour intervals.

  Collection

  Separate serum from cells within 45 minutes of collection.

  Reference notes

  • Total: See table. • LD1: 17% to 32% • LD2: 25% to 40% • LD3: 17% to 27% • LD4: 5% to 13% • LD5: 4% to 20% Age Male (IU/L)* Female (IU/L)* *LabCorp internal studies. 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 LD Isoenzyme Interpretation Abbrev* Total LDH LD1 LD2 LD3 LD4 LD5 *See following interpretation of abbreviations. H = high (increased). − = within reference (normal) interval or decreased. N = within reference (normal) interval. Case 1 H H H − − − Case 2 H H H − − − Case 3 H H> H − − − Case 4 H H> H − − H Case 5 H H H − − H Case 6 H − − − H H Case 7 H − H H H − Case 8 H H H H H H Case 9 H − − − − − Case 10 N − − − − − Case 11 H − − − − H Case 12 Other patterns not shown above Interpretations: • Case 1: Patient specimen was visibly hemolyzed, which may have produced the elevations of LD1 and LD2 on the LD isoenzyme pattern. • Case 2: The LD isoenzyme pattern demonstrates elevations of LD1 and LD2. These increases would be compatible with diagnostic considerations involving myocardial infarction, megaloblastic anemia, acute renal infarction, in vivo hemolytic process (eg, hemolytic anemia), or in the later stages of muscular dystrophy. • Case 3: The LD isoenzyme pattern demonstrates LD1 greater than LD2. In the appropriate clinical setting, this pattern is most compatible with postmyocardial infarction occurring at least 8 to 12 hours prior to venipuncture. • Case 4: The LD isoenzyme pattern demonstrates LD1 greater than LD2 and an increase of LD5. This pattern would be most compatible with passive hepatic congestion following an acute myocardial infarction or right-sided congestive heart failure associated with myocardial infarction. • Case 5: The LD isoenzyme pattern demonstrates elevations of LD1 and LD2 and an increase of LD5. This pattern would be compatible with diagnostic considerations involving passive hepatic congestion or right-sided congestive heart failure which may have followed acute myocardial damage. • Case 6: The LD isoenzyme pattern demonstrates elevations of LD4 and LD5. These increases would be compatible with hepatic (cirrhosis, viral hepatitis, toxic hepatitis) or skeletal muscle injury. This pattern may also be associated with congestive heart failure. • Case 7: The LD isoenzyme pattern demonstrates elevations of LD2, LD3, and LD4. Increases of these isoenzymes fractions are nonspecific but have been associated with septic shock, pulmonary emboli, and some neoplastic processes. • Case 8: The LD isoenzyme pattern demonstrates elevations of all isoenzymes without dominating fractions. This pattern is nonspecific but has been associated with septic shock, pulmonary emboli, and some neoplastic processes. • Case 9: The LD isoenzyme pattern appears normal despite elevation of the total LD. The LD total is significantly elevated, and there is no increase in the relative percentage of any fraction. The LD isoenzyme pattern is an "isomorphic pattern." This pattern may be seen with neoplasia, cardiorespiratory diseases, hypothyroidism, infectious mononucleosis, and other inflammatory states, uremia, and necrosis. • Case 10: The LD isoenzyme pattern appears normal with a normal total LD. • Case 11: The LD isoenzyme pattern demonstrates an elevated LD5 fraction which may be associated with hepatic anoxia due to congestive heart failure or the early stages of muscular dystrophy. • Case 12: The LD isoenzyme pattern is nonspecific. Recommend correlation with the clinical condition of the patient.

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• Creatine Kinase (CK) and Lactate Dehydrogenase (LD), Totals and Isoenzymes 001859

  12 analytes · Serum · Fasting not stated · Turnaround 4 - 7 days

  Method and collection

  Method

  Total: kinetic; Isoenzymes: agarose gel electrophoresis with densitometry

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• COVID-19 Poor Outcomes Risk Profile 164081

  21 analytes · Serum · Fasting not stated · Turnaround 1 - 2 days

  Method and collection

  Method

  See individual test components.

  Collection

  Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells.Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No. 49482). Freeze plasma within four hours of blood collection and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit seperate frozen specimens for each test requested.

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• COVID-19 Severe Disease Progression Risk Profile 164049

  25 analytes · Serum · Fasting not stated · Turnaround 2 - 4 days

  Method and collection

  Method

  See individual test components.

  Collection

  Blood should be collected in a blue-top tube containing 3.2% buffered sodium citrate. Evacuated collection tubes must be filled to completion to ensure a proper blood to anticoagulant ratio. The sample should be mixed immediately by gentle inversion at least six times to ensure adequate mixing of the anticoagulant with the blood. A discard tube is not required prior to collection of coagulation samples. When noncitrate tubes are collected for other tests, collect sterile and nonadditive (red-top) tubes prior to citrate (blue-top) tubes. Any tube containing an alternate anticoagulant should be collected after the blue-top tube. Gel-barrier tubes and serum tubes with clot initiators should also be collected after the citrate tubes. Centrifuge and carefully remove the plasma using a plastic transfer pipette, being careful not to disturb the cells.Transfer the plasma into a Labcorp PP transpak frozen purple tube with screw cap (Labcorp No 49482). Freeze plasma within four hours of blood collection and maintain frozen until tested. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit seperate frozen specimens for each test requested.

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Single-analyte tests

• Lactate Dehydrogenase (LD) 593

  Serum · Fasting not stated · Turnaround Set up: Mon-Sat; Report available: 3 days

  Method and collection

  Method

  Spectrophotometry (SP)

  Collection

  Do not refrigerate or freeze

  Quest Diagnostics catalog page

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Panels that include this biomarker

• Lactate Dehydrogenase (LD) Isoenzyme Panel 4411

  6 analytes · Serum · Fasting not stated

  Method and collection

  Method

  Electrophoresis • Spectrophotometry (SP)

  Collection

  Centrifuge serum specimens within 1 hour of collection, transfer serum to a clean, plastic, transport tube(s), and transport at room temperature to the laboratory. Do not refrigerate or freeze the specimens. Specimens cannot be shared, and no other tests should be ordered with Lactate Dehydrogenase Isoenzymes.

  Reference notes

  ⁠⁠⁠⁠⁠⁠⁠Lactate Dehydrogenase (LD) Male (U/L) | Female (U/L) <1 Month | 125-735 | 145-765 1-11 Months | 170-450 | 190-420 1-3 Years | 155-345 | 165-395 4-6 Years | 155-345 | 135-345 7-10 Years | 140-270 | 140-270 11-13 Years | 110-250 | 110-250 14-17 Years | 110-230 | 110-230 18-49 Years | 100-220 | 100-200 >49 Years | 120-250 | 120-250 Lactate Dehydrogenase Isoenzymes LD1 | 18-32 % LD2 | 29-42 % LD3 | 14-30 % LD4 | 6-13 % LD5 | 5-18 %

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