Individuals, more specifically adults at risk of developing sickle cell disease related complications could be identified by a simple test that measures the levels of the enzyme lactate dehydrogenase (LDH). Sickle cell disease is a genetic disorder characterized by sickle shaped red blood cells with compromised oxygen carrying capacity.
Kidney, heart, liver and red blood cells are some rich sources of the enzyme, although trace amounts of the enzyme can be found in other cell types. Under diseased conditions, the cells that contain the enzyme release the same, leading to elevated levels of the enzyme in the same.
The researchers analyzed the LDH levels in over 213 adults, diagnosed with sickle cell disease. The study participants were divided into three groups based on their serum LDH level (high, medium, low). Individuals with high LDH levels (512-1171 IU/L) had a higher incidence of disease related complications such as priapism (persistent painful erections), leg ulcerations and pulmonary hypertension. The severity of the complication could be correlated to the LDH level. Furthermore, the survival rate of those with high LDH levels was comparatively lower than the other two groups.
Following these findings, it has been suggested that a measurement of LDH level can be used to determine the progress of the disease and provide an estimate of the associated complication risk. It can even predict which patients will survive longer.
The correlation of the LDH levels and the disease severity was found to be independent of the standard treatment with hydroxyurea. Vaso-occlusive cries, caused due to the sickle shaped RBC's obstructing the blood vessels, a hallmark of sickle cell disease were also not found to influence LDH levels. The results of this clinically important study can be found in the latest issue of Blood, a journal published by the American Society of Hematology.
'LDH levels illuminate a pattern of pathology in sickle cell disease patients. This study suggests that LDH testing may be a worthwhile addition to 'well adult' visits for individuals with sickle cell anemia, though the significance in children and adolescents, remains unclear. As a result, LDH appears to hold great promise as an effective indicator for identifying patients most at risk and in need of possible preventive care and careful monitoring,' concluded the researchers.