Lactate dehydrogenase as predictor for severity in sickle cell disease

Abstract

Introduction: Pyruvate to lactate in a glycolytic pathway is caused by enzyme lactate dehydrogenase (LDH) with the conversion of NADH TO NAD+. Lactate dehydrogenase can be found in different body tissues. For hemolysis marker lactate dehydrogenase levels can be used. In sickle cell anaemia patient those who are in the steady-state (SS) there will be an increase in the level of lactate dehydrogenase(LDH). In sickle cell disease, the life of the patient is hampered due to crisis and it is very difficult to predict the crisis. Hence in our study, we used a marker lactate dehydrogenase (LDH ) to predict the severity of the crisis. Objectives: To study the ability of serum LDH levels in predicting the severity of disease in sickle cell anaemia. Methodology: To achieve the objective we assess serum LDH levels during steady-state and crisis and to correlate above with chronic complications (PH, Microalbuminuria, Liver functions) and severity of the crisis.Patients fulfilling selection criteria will be recruited after obtaining written consent. Detailed history including the age of onset, frequency and severity of the crisis, frequency of admissions and transfusions, quality of follow up, quality of treatment received will be taken. Detailed examination including anthropometry will be recorded. The severity of the acute crisis will be decided based on the duration of pain more than 2 days, need for admission & stay more than 3 days, death, need for surgery, need for support and need for other procedure. Expected Results: We expect the LDH level to be significantly higher during the crisis. If steady-state patients are considered LDH level will be high in patients with moderate and severe disease (frequency more than 3/ year).