Abstract
ContextAn increase in enzyme lactate dehydrogenase (LDH) in serum is a negative prognostic factor for survival in cats affected by lymphoma. Measuring LDH at the time of diagnosis has been studied for differentiating neoplastic disease from non-neoplastic disease in dogs. Inflammatory bowel disease (IBD) and alimentary lymphoma are common diseases in cats.ObjectiveThe aim of this study was to determine whether elevation of total LDH occurred in cats with alimentary lymphoma and non-neoplastic gastrointestinal disease, such as IBD, and to evaluate whether this enzyme is useful in supporting the differential diagnosis of these specific diseases.Materials and MethodsA prospective non-randomized controlled study was carried-out in a real world setting of three Italian private veterinary clinics. Seventy-one client-owned cats with a history of chronic gastrointestinal symptoms were enrolled; 33 cats were histologically diagnosed as having alimentary lymphoma and 38 cats as having IBD. Serum samples of total LDH analysis were measured.ResultsGender (P = 0.016) and age (P = 0.046) were found to be significant factors influencing the differentiation of serum total LDH between cats with alimentary lymphoma and those with IBD. Despite low diagnostic accuracy in the overall population (63%), a cut-off value of serum total LDH ranging from 0.85- to 1.04-times the upper reference limit showed good capability (accuracy >80%) of differentiating these two conditions in neutered males and cats younger than 8 years of age (AUC: 0.805, 0.833; sensitivities: 76.9%, 83.3%; specificities: 80.0%, 76.5%; PPV: 76.9%, 55.6%; NPV: 80.0%, 92.9%; respectively).ConclusionsAlthough our study showed that gender and age are significant factors in differentiating serum total LDH between cats with alimentary lymphoma and those with IBD, this test had poor diagnostic accuracy in differentiating between these two conditions in the overall population.
Highlights
Lactate dehydrogenase (LDH) is an enzyme which catalyzes the last step of the conversion of pyruvate to lactate during anaerobic glycolysis
Gender (P = 0.016) and age (P = 0.046) were found to be significant factors influencing the differentiation of serum total LDH between cats with alimentary lymphoma and those with Inflammatory bowel disease (IBD)
Serum total LDH ranging from 0.85- to 1.04-times the upper reference limit showed good capability of differentiating these two conditions in neutered males and cats younger than 8 years of age (AUC: 0.805, 0.833; sensitivities: 76.9%, 83.3%; specificities: 80.0%, 76.5%; positive predictive value (PPV): 76.9%, 55.6%; negative predictive value (NPV): 80.0%, 92.9%; respectively)
Summary
Lactate dehydrogenase (LDH) is an enzyme which catalyzes the last step of the conversion of pyruvate to lactate during anaerobic glycolysis. Lactate dehydrogenase is found in the cells of almost all body tissues. There are five isoenzymes with LDH activity. Different normal human tissues contain different patterns of these five isoenzymes [1]. Alteration in LDH isoenzyme levels has been observed during development, under changing biological conditions and in response to pathological processes. Lactate dehydrogenase activity in serum increases as a marker of cellular necrosis [2]
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