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Updated: Jul 5, 2026
Mapping Metabolism: Monitoring Lactate Dehydrogenase Activity Directly in Tissue
Published on: June 21, 2018
Lactate dehydrogenase activity is increased in plasma of infants with advanced necrotizing enterocolitis
Francesco Morini1, Ida di Crosta, Maria P Ronchetti
1Neonatal Surgery Unit, Bambino Gesù Children's Hospital, Piazza S. Onofrio, 4, 00165, Rome, Italy. francesco.morini@opbg.net
Insights
Serum lactate dehydrogenase (LDH) activity may indicate intestinal gangrene in infants with necrotizing enterocolitis (NEC). Elevated LDH levels could aid surgeons in making critical decisions for NEC patients.
Area of Science:
- Pediatric Surgery
- Neonatal Gastroenterology
- Biochemical Markers
Background:
- Necrotizing enterocolitis (NEC) is a severe neonatal condition.
- Intestinal gangrene signifies advanced NEC, often linked to ischemia.
- Elevated serum enzymes may signal intestinal damage in NEC.
Purpose of the Study:
- To investigate if serum enzyme activity is elevated in infants with NEC and intestinal gangrene.
- To determine the diagnostic value of specific serum enzymes in advanced NEC.
Main Methods:
- Retrospective review of NEC patients operated on between 1998 and 2006.
- Comparison of preoperative serum enzyme activities (ALP, GOT, CK, LDH) between infants with (Group A) and without (Group B) intestinal gangrene.
Main Results:
- Eighteen infants met inclusion criteria; 12 in Group A and 6 in Group B.
- Significantly higher serum lactate dehydrogenase (LDH) activity was observed in Group A (1131.0 IU/L) compared to Group B (482.0 IU/L) (P < 0.005).
Conclusions:
- Serum LDH activity may be elevated in infants with NEC complicated by intestinal gangrene.
- LDH evaluation could serve as a valuable adjunct in surgical decision-making for NEC management.
Abstract:
In infants with necrotizing enterocolitis (NEC), intestinal gangrene defines advanced disease. Since intestinal ischemia is considered a pathogenetic factor for intestinal gangrene, serum activity of mucosal and seromuscular enzymes may be elevated in these patients. Our aim was to evaluate if serum enzymes activity is increased in infants with NEC associated with intestinal gangrene. We performed a retrospective review of the case notes of infants operated on for NEC between 1998 and 2006. Patients with preoperative determination of serum enzymes were included in the study, and were divided into Group A and Group B based on the presence or absence of intestinal gangrene, respectively. Serum activities of alkaline phosphatase (ALP), glutamic oxaloacetic transaminase (GOT), creatine kinase (CK), and lactate dehydrogenase (LDH) were compared in the two Groups. Values are medians (interquartile range). Thirty-five infants were operated on for NEC in the study period. Eighteen patients fulfilled the inclusion criteria: 12 in Group A and six in Group B. Group A patients had significantly higher LDH activity [1131.0 (1092.0-1300.0) vs. 482.0 (440.0-624.5) IU/L; P < 0.005]. Our findings suggest that LDH activity may be increased in infants with NEC and intestinal gangrene. Its evaluation could be a further tool in the surgical decision making process in infants with NEC.
