Lactic Acid Dehydrogenase Activity and Plasma Hemoglobin Elevations in Sickle Cell Disease

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Abstract
Lactic dehydrogenase and plasma hemoglobin are usually elevated to about twice normal in the steady state of sickle cell anemia. On the 1st day of a febrile, painful crisis, plasma hemoglobin or lactic dehydrogenase activity (or both) further increase to 4 or 5 times normal and the lactic dehydrogenase isozyme pattern shows a predominance of Isozymes 1 and 2. The wide fluctuation of plasma hemoglobin in the steady state limits its usefulness in differentiating crisis from other illnesses; however, elevations of lactic dehydrogenase of over 1000 Wroblewski units would suggest a febrile, painful crisis.

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