high ldh

Recently I was selected as a bone marrow donor. During the routine physical screening process they saw a ldh of 1133 and directed to my primary doctor. A followup test had an ldh of 533 and bilirubin of 1.6. I am a very healthy, physically active 48 year non smoker/drinker. Fraction ldh were all in normal ranges(fraction 3 was 29). My primary doctor had no idea what was wrong and sent me to a hemotologist. He orders another round of blood work and a sonogram which reveals a slightly enlarged liver and spleen. He has now sent me to a nuclear mri type lab to check out the liver and spleen and another round of blood/urine tests. I feel fine and if not for the bone donor screen never would have even seen my doctor. Needless to say, my head is spinning while we are trying to pin down what is going on. The only out of the ordinary things I could think of was extra strenuous workouts (5 mile run,weight lifting) and a trip to Italy (bad water?). I had taken too much aspirin a year or so ago. I really would like to complete the donor program but obviously that is on hold. Any advice?

[Kevin Pho, MD]

I agree with the workup thus far.  By itself, the LDH is not very specific - there are a variety of conditions that can raise this level.  

This can include different types of hemolytic anemias, liver/pancreatic disease, bone cancers, viral illness of kidney diseases.

I agree with the hematology workup.  If a blood cause is suspected, a bone marrow biopsy can be conducted.

A referral to a liver specialist can be done if the hematology workup is non-revealing.

These options can be discussed with your personal physician.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com