LDH Lactate Dehydrogenase Off The Charts - Why?

[DanBro1]

I completed my 12 months Obinutuzumab/Venclexta treatment regimen March 1st. I go tomorrow (Friday, May 27, 2022) for my first doctor visit since ending treatment. I feel great. No problems that I know of....BUT. Yesterday I went to the lab to have blood drawn and tests run in preparation of my Friday office visit. One blood test came back off the charts. LDH Lactate Dehydrogenase has gone crazy. Anyone else had this issue???

[lankisterguy Volunteer]

Hi DanBro1

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The simplest answer is that a high LDH means that more cells than normal are breaking down somewhere in your body. ( Its like a "check engine" light on your car- it says there is something out of the ordinary happening, but you need further testing to find out where)

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See: webmd.com/a-to-z-guides/lac...

medlineplus.gov/lab-tests/l...

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Your doctor will likely start a differential diagnosis to check for common causes, and ask about any symptoms, enlarged nodes, etc. to see if any form of aggressive blood cancer is a potential cause. If you had strenuous exercise or activities a day or so before the test that could be a cause.

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Like most abnormal tests, your doctor will likely run the test again, and check whether earlier the blood sample was mishandled in any way that could break down red cells, etc.

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Len

[DanBro1 in reply to lankisterguy]

Thank you, Lankisterguy. I will post what my doc thinks after tomorrow's visit......

[AussieNeil Partner Administrator]

Given you feel great, I expect that the cause is mishandling of your blood sample as Len suggested or perhaps great difficulty taking it. I've had a few very high LDH results due to this. On one occasion a new phlebotomist struggled so much to draw my blood sample, that the supervising phlebotomist took over. I had a noticeable amount of bruising afterwards. On another occasion, there was a note with my blood test results that some counts were likely to be incorrect due to haemolysis (destruction of red blood cells). I've also posted previously about the fairly widespread practice of putting blood samples out for collection in collection boxes exposed to heat from the sun. That can cause haemolysis and hence a high LDH. If you went direct to the processing lab and not a collection centre, then that wouldn't be the cause, but your blood sample could still have been mishandled.

Neil

[DanBro1 in reply to AussieNeil]

Neil.... You are the best!!! Everything was OK going back to the first of the year, then suddenly a huge spike yesterday. I believe it is just a mishandling/misreading/corruption of the blood sample like you suggest!! Thanks, again.

[Jm954 Administrator in reply to AussieNeil]

Poor sampling or handling of the sample is definitely the most likely reason for this result, as Neil says.Jackie