Annals of Tropical Medicine & Parasitology
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Plasma lactate dehydrogenase estimation in the diagnosis of malaria P. Klenerman, H. Dickson & G. A. Luzzi To cite this article: P. Klenerman, H. Dickson & G. A. Luzzi (1992) Plasma lactate dehydrogenase estimation in the diagnosis of malaria, Annals of Tropical Medicine & Parasitology, 86:5, 563-565, DOI: 10.1080/00034983.1992.11812708 To link to this article: http://dx.doi.org/10.1080/00034983.1992.11812708
Published online: 15 Nov 2016.
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Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ypgh19 Download by: [Australian Catholic University]
Date: 09 August 2017, At: 03:07
Annals of Tropical Medicine and Parasitology, Vol. 86, No.5, 563-565 (1992)
Downloaded by [Australian Catholic University] at 03:07 09 August 2017
Plasma lactate dehydrogenase estimation in the diagnosis of malaria In patients who return to the U.K. from abroad with a fever, repeated blood films may be needed to exclude malaria. If the history and examination do not point to an alternative diagnosis, there may be clues from routine laboratory tests; a low haemoglobin level or platelet count, for example, might lead the clinician to pursue malaria further, although they are by no means specific (Bradley et a!., 1989). Other patients may be unwilling or unable to stay for repeated blood tests and it would therefore be of value to have confirmatory tests to accompany a single negative blood film. Lactate dehydrogenase (LDH) is an enzyme found in many tissues, and is present in red blood cells, liver and muscle. Elevated plasma LDH levels have been demonstrated in severe cases of malaria with anaemia (Phillips et a!., 1986). In a prospective study, we tested the
hypothesis that measurement of the plasma LDH levels in febrile travellers would be of value in distinguishing those with malaria from those with other causes offever. Forty-one consecutive patients with fever associated with fever abroad, seen at the Infectious Diseases Unit in Oxford, U.K., were studied. All had travelled within regions endemic for malaria; 25 in Africa and 16 in Asia. None had been treated with an antimalarial before reaching hospital. Blood was taken, at the time of the first visit, for full blood counts, assays for urea, electrolytes, C-reactive protein (CRP) and LDH, and liver blood tests. Plasma LDH levels were estimated within 12 hours of blood collection, using the American Monitors system. Thick and thin blood smears from each patient were stained with 20% (v/v) Giemsa and
TABLE Comparison ofpatients with malaria and other febrile illnesses*
Sex (female:male) Age Temperature (0 C) Haemoglobin (g/dl) White cells ( x I 09jl) Platelets ( x 109jl) CRP(mg/dl) Bilirubin (1-lmol/1) AST(IU/1) ALP (IU/1) LDH(IU/1)
Malaria (N=l7)
Other febrile illness (N =24)
9:8 29± 10 38·7±0·7 13-1±2·4 4± 1·1 139 ± 63 6·7±8·6 18± 13 69±71 143± 17 345 ± 186
13: II 33 ±II 38±0·9 14± 1·5 7·1 ±2·8 242±67 2·7±3·5 11 ± 15 46±34 164± 104 178±60
Pt N.S.
ISSN: 0003-4983 (Print) 1364-8594 (Online) Journal homepage: http://www.tandfonline.com/loi/ypgh19
Plasma lactate dehydrogenase estimation in the diagnosis of malaria P. Klenerman, H. Dickson & G. A. Luzzi To cite this article: P. Klenerman, H. Dickson & G. A. Luzzi (1992) Plasma lactate dehydrogenase estimation in the diagnosis of malaria, Annals of Tropical Medicine & Parasitology, 86:5, 563-565, DOI: 10.1080/00034983.1992.11812708 To link to this article: http://dx.doi.org/10.1080/00034983.1992.11812708
Published online: 15 Nov 2016.
Submit your article to this journal
View related articles
Citing articles: 3 View citing articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ypgh19 Download by: [Australian Catholic University]
Date: 09 August 2017, At: 03:07
Annals of Tropical Medicine and Parasitology, Vol. 86, No.5, 563-565 (1992)
Downloaded by [Australian Catholic University] at 03:07 09 August 2017
Plasma lactate dehydrogenase estimation in the diagnosis of malaria In patients who return to the U.K. from abroad with a fever, repeated blood films may be needed to exclude malaria. If the history and examination do not point to an alternative diagnosis, there may be clues from routine laboratory tests; a low haemoglobin level or platelet count, for example, might lead the clinician to pursue malaria further, although they are by no means specific (Bradley et a!., 1989). Other patients may be unwilling or unable to stay for repeated blood tests and it would therefore be of value to have confirmatory tests to accompany a single negative blood film. Lactate dehydrogenase (LDH) is an enzyme found in many tissues, and is present in red blood cells, liver and muscle. Elevated plasma LDH levels have been demonstrated in severe cases of malaria with anaemia (Phillips et a!., 1986). In a prospective study, we tested the
hypothesis that measurement of the plasma LDH levels in febrile travellers would be of value in distinguishing those with malaria from those with other causes offever. Forty-one consecutive patients with fever associated with fever abroad, seen at the Infectious Diseases Unit in Oxford, U.K., were studied. All had travelled within regions endemic for malaria; 25 in Africa and 16 in Asia. None had been treated with an antimalarial before reaching hospital. Blood was taken, at the time of the first visit, for full blood counts, assays for urea, electrolytes, C-reactive protein (CRP) and LDH, and liver blood tests. Plasma LDH levels were estimated within 12 hours of blood collection, using the American Monitors system. Thick and thin blood smears from each patient were stained with 20% (v/v) Giemsa and
TABLE Comparison ofpatients with malaria and other febrile illnesses*
Sex (female:male) Age Temperature (0 C) Haemoglobin (g/dl) White cells ( x I 09jl) Platelets ( x 109jl) CRP(mg/dl) Bilirubin (1-lmol/1) AST(IU/1) ALP (IU/1) LDH(IU/1)
Malaria (N=l7)
Other febrile illness (N =24)
9:8 29± 10 38·7±0·7 13-1±2·4 4± 1·1 139 ± 63 6·7±8·6 18± 13 69±71 143± 17 345 ± 186
13: II 33 ±II 38±0·9 14± 1·5 7·1 ±2·8 242±67 2·7±3·5 11 ± 15 46±34 164± 104 178±60
Pt N.S.
