Lactic Acid Dehydrogenase Activity and Plasma Hemoglobin Elevations in Sickle Cell Disease

Abstract

Lactic dehydrogenase and plasma hemoglobin are usually elevated to about twice normal in the steady state of sickle cell anemia. On the 1st day of a febrile, painful crisis, plasma hemoglobin or lactic dehydrogenase activity (or both) further increase to 4 or 5 times normal and the lactic dehydrogenase isozyme pattern shows a predominance of Isozymes 1 and 2. The wide fluctuation of plasma hemoglobin in the steady state limits its usefulness in differentiating crisis from other illnesses; however, elevations of lactic dehydrogenase of over 1000 Wroblewski units would suggest a febrile, painful crisis.