Spinal Fluid Lactate Dehydrogenase Level Differentiates between Structural and Metabolic Etiologies of Altered Mental Status in Children

Nahid KHOSROSHAHI, Parastoo ALIZADEH, Mehdi KHOSRAVI, Peyman SALAMATI, Kamyar KAMRANI*

Abstract


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How to Cite This Article: Khosroshahi N, Alizadeh P, Khosravi M, Salamati P, Kamrani K. Spinal Fluid Lactate Dehydrogenase Level Differentiates between Structural and Metabolic Etiologies of Altered Mental Status in Children. Iran J Child Neurol. 2015 Winter;9(1):31-36.

Abstract
Objective
Altered mental status is a common cause of intensive care unit admission in
children. Differentiating structural causes of altered mental status from metabolic etiologies is of utmost importance in diagnostic approach and management of the patients. Among many biomarkers proposed to help stratifying patients with altered mental status, spinal fluid lactate dehydrogenase appears to be the most promising biomarker to predict cellular necrosis.


Materials & Methods
In this cross sectional study we measured spinal fluid level of lactate
dehydrogenase in children 2 months to 12 years of age admitted to a single center intensive care unit over one year. Spinal fluid level of lactate dehydrogenase in 40 pediatric cases of febrile seizure was also determined as the control group.


Results
The study group included 35 boys (58.3%) and 25 girls (41.7%). Their mean
age was 2.7+/-3 years and their mean spinal fluid lactate dehydrogenase level
was 613.8+/-190.4 units/liter. The control group included 24 boys (55.8%) and
19 girls (44.2%). Their mean age was 1.3+/-1.2 years and their mean spinal
fluid lactate dehydrogenase level was 18.9+/-7.5 units/liter. The mean spinal
fluid lactate dehydrogenase level in children with abnormal head CT scan was
246.3+/-351.5 units/liter compared to 164.5+/-705.7 in those with normal CT
scan of the head (p=0.001).

Conclusion
Spinal fluid lactate dehydrogenase level is useful in differentiating structural and
metabolic causes of altered mental status in children.

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Keywords


Lactate dehydrogenase; Cerebrospinal fluid; Altered mental status; Brain imaging

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DOI: https://doi.org/10.22037/ijcn.v9i1.5456

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