Adjustments of serum lactate dehydrogenase isoenzymes and their significance in monitoring the treatment in patients with tubercular pyothorax.

The adjustments and diagnostic significance of polyacrylamide gel electrophoretic (PAGE) profiles of lactate dehydrogenase isoenzymes (LDH: 1.1.1.27) was evaluated in the sera and pleural fluid of patients with tubercular pyothorax. Sera and pleural fluid samples were randomly collected from 72 and 18 patients respectively at two different timings; first, when patients were admitted to the Hospital and second, after an intensive phase of treatment. Sera of 20 healthy individuals served as control. Our results demonstrate significant differences in sera LDH (sLDH) and pleural fluid LDH (pfLDH) isoenzymes. In patients the order of LDH isoenzyme in sera and pleural fluid followed: LDH-5>-4>-2>-3>-1 and LDH-5>-4>-3>-2>-1 respectively. The ranking of activity levels in control was LDH-2>-1>-3>-5>-4. In the second phase of sampling from 31 patients, values of sLDH isoenzymes showed recovery and resembled profiles of controls. Therefore, the sLDH zymograms of patients can be used as the prognostic marker, since they tend to reach the normal level during recovery signifying the effect of chemotherapy in hospitalized patients. Moreover, according to the present findings on LDH-PAGE profiles, the levels of LDH-5 and-4 rise in pyothorax patients significantly (P<0.05). This elevation along with the rise in total LDH activity may, therefore, be used in the diagnosis and monitoring of tubercular pyothorax.