Hepatic infarction: biochemical study of a case

Area of Science:

• Medicine
• Biochemistry
• Pathology

Background:

• Aortic dissection can lead to serious complications affecting multiple organs.
• Hepatic infarction, though rare, presents diagnostic challenges.
• Understanding enzyme markers is crucial for diagnosing non-ischemic organ damage.

Observation:

• Post-mortem examination revealed hepatic infarction in a young male patient who died from aortic dissection.
• Serum samples showed markedly elevated aspartate aminotransferase and alanine aminotransferase.
• Alkaline phosphatase and gamma-glutamyltransferase levels were only marginally increased.

Findings:

• A threefold increase in total lactate dehydrogenase (LDH) was primarily due to a ninefold rise in LD-5 isoenzyme.
• A threefold increase in creatine kinase (CK) was attributed solely to CK-3, indicating muscle breakdown.
• Elevated serum enzyme activities associated with hepatocellular necrosis suggest rapid changes in hepatic infarction.

Implications:

• Serum enzyme profiles, especially LD-5, can serve as indicators of acute hepatic infarction.
• Creatine kinase isoenzyme analysis is a valuable supplementary diagnostic tool when LD-5 levels are significantly elevated.
• Early recognition of hepatic infarction in patients with aortic dissection is critical for timely management.