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LDH isoenzymes in CSF in the diagnosis of neonatal brain damage
Insights
Elevated lactate dehydrogenase (LDH) isoenzymes LDH2 and LDH3 in cerebrospinal fluid may indicate anoxic brain damage in newborns. Higher levels correlate with poorer outcomes in asphyctic infants.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Neurology
Background:
- Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal mortality and morbidity.
- Cerebrospinal fluid (CSF) biomarkers are crucial for diagnosing and assessing brain injury in neonates.
Purpose of the Study:
- To investigate the diagnostic value of lactate dehydrogenase (LDH) isoenzymes in CSF for assessing anoxic brain damage in neonates.
- To correlate CSF LDH isoenzyme patterns with clinical outcomes in asphyctic neonates.
Main Methods:
- Measurement of LDH isoenzymes (LDH1-5) in CSF within the first 24 hours of life.
- Clinical and developmental follow-up examinations for a mean period of 15.2 months.
- Comparison of LDH isoenzyme levels between neonates with different outcomes (death, neurological sequelae, normal survival).
Main Results:
- Significantly higher mean values of LDH2 and LDH3 isoenzymes were observed in asphyctic neonates who died from HIE or survived with neurological sequelae.
- Asphyctic neonates who survived without neurological deficits showed lower CSF LDH2 and LDH3 levels compared to those with adverse outcomes.
Conclusions:
- The pattern of lactate dehydrogenase isoenzymes in cerebrospinal fluid can serve as a valuable indicator for assessing anoxic brain damage in neonates.
- CSF LDH isoenzyme analysis may aid in predicting neurological outcomes in infants affected by perinatal asphyxia.
Abstract:
Lactate dehydrogenase isoenzymes in cerebrospinal fluid were measured during the first 24 h of life in 25 asphyctic neonates. The infants were subjected to clinical and developmental examinations for a mean follow-up period of 15.2 months. The mean values for cerebrospinal LDH2(MH3) and LDH3(M2H2) isoenzymes were significantly higher in asphyctic infants who died from hypoxic-ischemic encephalopathy or who survived but suffered neurologic sequelae, than they were in those asphyctic infants who survived and were normal in the follow-up studies. Therefore, the authors conclude that the lactate dehydrogenase isoenzyme pattern in cerebrospinal fluid may be of value when assessing anoxic brain damage.