Increased serum activity of lactate dehydrogenase in infants with necrotizing enterocolitis: a potential marker of advanced disease

Asphyxiated neonates have an increased serum activity of selected enzymes. Since hypoxia/ischaemia is a pathogenetic factor for necrotising enterocolitis (NEC), the serum activity of these enzymes may also be increased in infants with NEC. Our aim was to evaluate whether the serum activity of selected enzymes was increased in patients with NEC, particularly those with advanced disease. A retrospective review of all infants treated for NEC between 1998 and 2006 was undertaken. Patients with suspected NEC or focal intestinal perforation were excluded. Patients with definite (group A) and advanced (group B) NEC and a determination of serum activity of alkaline phosphatase, creatinine kinase, glutamic oxaloacetic transaminase and lactate dehydrogenase were included in the study. Maximum serum activity during the course of the disease was determined and compared in the two groups by the Mann–Whitney test. Thirty-seven infants with definite (24) or advanced (13) NEC had a determination of serum enzymes activity at some stage of their disease. Group B patients had significantly higher activity of lactate dehydrogenase (p < 0.05) and a trend towards higher creatinine kinase activity. The serum activity of selected enzymes may thus be increased in infants with advanced NEC. Evaluation of this parameter could be an additional tool in the surgical decision-making process in infants with this disease.