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Lactic Dehydrogenase Activity of Effusion Fluids as an Aid to Differential Diagnosis

Russell J. Erickson, M.D.
[+] Author Affiliations

San Francisco

Mr. Erickson is a research fellow at the Cancer Research Institute, University of California School of Medicine, San Francisco, and will receive his M.D. degree June 9, 1961.


JAMA. 1961;176(9):794-796. doi:10.1001/jama.1961.63040220001008
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THE DETECTION of malignancy in patients with effusions of unknown etiology often presents a difficult challenge. Wroblewski and Wroblewski,1 attempting to facilitate such diagnosis, found that the presence or absence of malignancy was indicated by the relative activities of the enzyme lactic dehydrogenase in the patient's serum and effusion fluid. Where effusion was of malignant origin, the lactic dehydrogenase (LDH) activity of the effusion fluid was higher than that of the simultaneously drawn serum. The reverse was true for effusions of non-malignant etiology. These results were confirmed by three later reports of F. Wroblewski2-4 and by Torregrosa.5

Although LDH activity was generally higher in effusion fluids accompanied by malignancy, Wroblewski and Wroblewski1 did not note a direct relationship between malignancy and the effusion fluid LDH activity per se. Their hypothesis, that effusions gained LDH from adjacent malignant cells, suggested that such a relationship might exist. A

REFERENCES

Wroblewski, F., and Wroblewski, R.:  Clinical Significance of Lactic Dehydrogenase Activity of Serous Effusions , Ann Intern Med 48:813-822 ( (April) ) 1958;.
Wroblewski, F.:  Clinical Significance of Alterations in Lactic Dehydrogenase Activity of Body Fluids , Amer J Med Sci 234:301-312 ( (Sept.) ) 1957;.
Wroblewski, F.:  Mechanisms of Alterations in Lactic Dehydrogenase Activity of Body Fluids , Ann N Y Acad Sci 75:322-338 ( (Oct. 13) ) 1958;.
Wroblewski, F.:  Significance of Alterations in Lactic Dehydrogenase Activity of Body Fluids in Diagnosis of Malignant Tumors , Cancer 12:27-39 ( (Jan.) -Feb.) 1959;.
de Torregrosa, M. V.:  Results of Lactic Dehydrogenase Determinations in Benign and Malignant Effusions , Amer J Med Sci 238:552-556 ( (Nov.) ) 1959;.
Hill, B. R., and Levi, C.:  Elevation of Serum Component in Neoplastic Disease , Cancer Res 14:513-515 ( (Aug.) ) 1954;.
White, L. P.:  Serum Enzymes: I. Serum Lactic Dehydrogenase in Myocardial Infarction , New Engl J Med 255:984-988 ( (Nov. 22) ) 1956;.
Hill, B. R.:  Some Properties of Serum Lactic Dehydrogenase , Cancer Res 16:460-467 ( (June) ) 1956;.

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Wroblewski, F., and Wroblewski, R.:  Clinical Significance of Lactic Dehydrogenase Activity of Serous Effusions , Ann Intern Med 48:813-822 ( (April) ) 1958;.
Wroblewski, F.:  Clinical Significance of Alterations in Lactic Dehydrogenase Activity of Body Fluids , Amer J Med Sci 234:301-312 ( (Sept.) ) 1957;.
Wroblewski, F.:  Mechanisms of Alterations in Lactic Dehydrogenase Activity of Body Fluids , Ann N Y Acad Sci 75:322-338 ( (Oct. 13) ) 1958;.
Wroblewski, F.:  Significance of Alterations in Lactic Dehydrogenase Activity of Body Fluids in Diagnosis of Malignant Tumors , Cancer 12:27-39 ( (Jan.) -Feb.) 1959;.
de Torregrosa, M. V.:  Results of Lactic Dehydrogenase Determinations in Benign and Malignant Effusions , Amer J Med Sci 238:552-556 ( (Nov.) ) 1959;.
Hill, B. R., and Levi, C.:  Elevation of Serum Component in Neoplastic Disease , Cancer Res 14:513-515 ( (Aug.) ) 1954;.
White, L. P.:  Serum Enzymes: I. Serum Lactic Dehydrogenase in Myocardial Infarction , New Engl J Med 255:984-988 ( (Nov. 22) ) 1956;.
Hill, B. R.:  Some Properties of Serum Lactic Dehydrogenase , Cancer Res 16:460-467 ( (June) ) 1956;.
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