The Journal of Dermatology Vol. 17: 477-481, 1990 .
Significance of Elevated Serum LDH (Lactate Dehydrogenase) Activity in Atopic Dermatitis Hideki Mukai, Toshihiko Noguchi, Kimio Kamimura, Kiyoshi Nishioka and Shigeo Nishiyama Abstract Serum lactate dehydrogenase activity (LDH) was elevated in most cases with the severe type of atopic dermatitis (AD). We examined whether LDH correlated specifically with the clinical courses and the severity of AD skin eruptions. Blood eosinophil numbers (Eo), LDH and its isoenzymes, and serum IgE (IgE) levels in eighty patients with AD were measured before and after treatment. In improved groups, Eo and LDH decreased or returned to normal values after treatment. In contrast, both levels increased in patients who worsened after treatment. Thus changes in Eo and LDH correlated well with the clinical picture. However, IgE levels did not correlate with the clinical condition. High LDH levels were detected in the severe type of AD more frequently than in the mild type. A large majority of patients with elevated LDH (higher than 300 lUll) before treatment had more severe skin eruptions. When the LDH before treatment was within normal limits, the LDH levels in improved patients showed a further decrease. Eo, LDH and IgE were correlated closely with the clinical scores of AD, and the relationship between LDH and clinical score was the highest. Elevations of LDH5 and LDH4 among the LDH isoenzymes were more prominent in the severe type of AD than in the mild type. We concluded that LDH was useful as a marker for evaluating the disease condition and severity of skin eruption of AD.
Key words: atopic dermatitis; LDH
Introduction Lactate dehydrogenase (LDH), an enzyme present in all cells, plays an important part in carbohydrate metabolism. High levels of serum LDH occur in patients with myocardial and skeletal muscle damage, liver disease, and so on. Isoenzyme analysis of LDH indicates the origin of elevated levels (1). Serum LDH levels have also been reported to be elevated in various skin diseases (2-8). Recent studies (3, 4) suggested that serum LDH5 elevations in eczema-associated erythroderma were correlated with the epidermal cell damage. In our Received March 12, 1990; accepted for publication]une 21,1990. Department of Dermatology, Kitasato University School of Medicine, Sagamihara,]apan. Reprint requests to: Dr. Hideki Mukai, Division of Dermatology, Tokyo Metropolitan Gediatric Hospital, 352 Sakae-cho, Itabashi 173,Japan.
study of the clinical course of AD, we found that serum LDH levels were elevated in more severe cases (9). In the present study, we examined whether serum LDH levels correlate specifically with the severity of AD skin eruptions. We report herein that serum LDH level can be a clinical marker for assessing the severity of AD.
Materials and Methods Eighty patients with AD ranging in age from l~ to 53 years were included in this study. The diagrt6sis was made on the basis of morphologic appearance and distribution of skin lesions, clinical course, and familial history of AD or atopic respiratory disease. They were divided into 3 groups, improved (40 cases), unchanged (20), and worsened (20), according to their clinical courses. Blood eosinophil numbers (Eo), LDH, and IgE (by RIST method) levels were measured before and after treatment. The normal ranges of LDH and IgE levels in our
478
Mukai et al Table 1. Eo, LDH and IgE levels before and after treatment Improved (40 cases) Eosinophil (/cmm)
Before After
1,001.6±626.1 499.3±349.8 (P
Significance of Elevated Serum LDH (Lactate Dehydrogenase) Activity in Atopic Dermatitis Hideki Mukai, Toshihiko Noguchi, Kimio Kamimura, Kiyoshi Nishioka and Shigeo Nishiyama Abstract Serum lactate dehydrogenase activity (LDH) was elevated in most cases with the severe type of atopic dermatitis (AD). We examined whether LDH correlated specifically with the clinical courses and the severity of AD skin eruptions. Blood eosinophil numbers (Eo), LDH and its isoenzymes, and serum IgE (IgE) levels in eighty patients with AD were measured before and after treatment. In improved groups, Eo and LDH decreased or returned to normal values after treatment. In contrast, both levels increased in patients who worsened after treatment. Thus changes in Eo and LDH correlated well with the clinical picture. However, IgE levels did not correlate with the clinical condition. High LDH levels were detected in the severe type of AD more frequently than in the mild type. A large majority of patients with elevated LDH (higher than 300 lUll) before treatment had more severe skin eruptions. When the LDH before treatment was within normal limits, the LDH levels in improved patients showed a further decrease. Eo, LDH and IgE were correlated closely with the clinical scores of AD, and the relationship between LDH and clinical score was the highest. Elevations of LDH5 and LDH4 among the LDH isoenzymes were more prominent in the severe type of AD than in the mild type. We concluded that LDH was useful as a marker for evaluating the disease condition and severity of skin eruption of AD.
Key words: atopic dermatitis; LDH
Introduction Lactate dehydrogenase (LDH), an enzyme present in all cells, plays an important part in carbohydrate metabolism. High levels of serum LDH occur in patients with myocardial and skeletal muscle damage, liver disease, and so on. Isoenzyme analysis of LDH indicates the origin of elevated levels (1). Serum LDH levels have also been reported to be elevated in various skin diseases (2-8). Recent studies (3, 4) suggested that serum LDH5 elevations in eczema-associated erythroderma were correlated with the epidermal cell damage. In our Received March 12, 1990; accepted for publication]une 21,1990. Department of Dermatology, Kitasato University School of Medicine, Sagamihara,]apan. Reprint requests to: Dr. Hideki Mukai, Division of Dermatology, Tokyo Metropolitan Gediatric Hospital, 352 Sakae-cho, Itabashi 173,Japan.
study of the clinical course of AD, we found that serum LDH levels were elevated in more severe cases (9). In the present study, we examined whether serum LDH levels correlate specifically with the severity of AD skin eruptions. We report herein that serum LDH level can be a clinical marker for assessing the severity of AD.
Materials and Methods Eighty patients with AD ranging in age from l~ to 53 years were included in this study. The diagrt6sis was made on the basis of morphologic appearance and distribution of skin lesions, clinical course, and familial history of AD or atopic respiratory disease. They were divided into 3 groups, improved (40 cases), unchanged (20), and worsened (20), according to their clinical courses. Blood eosinophil numbers (Eo), LDH, and IgE (by RIST method) levels were measured before and after treatment. The normal ranges of LDH and IgE levels in our
478
Mukai et al Table 1. Eo, LDH and IgE levels before and after treatment Improved (40 cases) Eosinophil (/cmm)
Before After
1,001.6±626.1 499.3±349.8 (P
