My 9 year old son has complained of minor leg pain...consistently in his left leg. We took him to an orthopedist who did some blood tests and an x-ray (which showed nothing). His LDH came back at 375. Normal range is 130-300. This was the only test that came back abnormal. The orthopedist is recommending a bones scan, which is a radioactive injection and scan. A friend of ours who is a hemotologist says there is no need for this or any concern. He says that the LDH is typically elevated during growth spurts of children and that 375 is not an alarming number. I don't know what to do. I don't want to put my child through any unnecessary radioactive tests, but I don't want to overlook something either.
Perhaps the reason why your son's orthopedist suggested further work-ups is because elevated LDH is associated with many types of malignancy.
I would suggest to have a repeat LDH determination in another laboratory facility and see if it is still elevated.
If it is still elevated, it would be best to have him checked by another doctor.
Is it true that during growth spurts the LDH would also be elevated? An oncologist we spoke to about this said there is typically no alarm unless the levels reach 600-700. We are going to have a bone scan, but until it is done I'm going to worry myself into an ulcer. His pain is completely gone. He has also told us that it never really hurt bad at all...he just wanted to get out of ball practice.
LDH originates in the muscle and liver.
Both neoplastic and non-neoplastic conditions that can cause elevation in LDH. Even strenuous exercises can cause elevation in LDH level.
Just like in any other laboratory examination, the result should be correlated clinically.
Just to give you an update...my son had a bone scan and everything is fine. The doctor just said to follow up with his ped. and have the LDH repeated in a few months. Possibly it was elevated b/c he did come down with a virus 2 days after the bloodtest. Maybe the virus was just brewing then. We are very thankful and very relieved.
I also have a 9 year old complaining of ankle, knee, hip pain with normal bloodwork except LDH of 270. I am worried sick because our clinic says normal is <180. He is an extremely athletic kid who is moving all the time. The LDH test we had taken was 3 days AFTER he had played in an extremely vigorous Basketball Tournament. Could the LDH stay elevated that long?
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