[Lactate dehydrogenase isoenzymes in patients with HELLP syndrome]

Lactate dehydrogenase (LDH) isoenzymes were serially measured in nine patients with HELLP syndrome during 01. 01. 1994-31. 01. 1995; at the time of the maxima of the total LDH we observed in 8/9 cases an absolute and relative maximum of LDH isoenzyme 5, that predominantly originates from the liver and from skeleton muscles, with coincident relative decrease of LDH isoenzymes 1 and 2, which are the predominant forms in heart muscle and erythrocytes. Therefore, total LDH can not be used as a marker of intravascular hemolysis in HELLP syndrome. The most sensitive marker for the hemolytic component of HELLP syndrome is the measurement of haptoglobin which should be included in laboratory screening in all cases with suspected HELLP syndrome.