Aldolase enzymatic

Blood

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No Fasting Required

Details

Enzyme involved in glycolysis; elevated in muscle damage.

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Aldolase Enzymatic Test - Comprehensive Medical Guide

Why is it done?
- Test measures the enzyme aldolase (also called fructose-1,6-bisphosphate aldolase), which is released into the bloodstream when muscle or liver cells are damaged or broken down
- Ordered to diagnose or monitor muscle diseases (myopathies) including muscular dystrophy, dermatomyositis, and polymyositis
- Used to evaluate liver damage or disease, including hepatitis, cirrhosis, and liver necrosis
- Performed when patients present with muscle weakness, pain, or elevated creatine kinase (CK) levels
- May be ordered following acute myocardial infarction (heart attack) or severe muscle trauma
- Used to monitor treatment efficacy in inflammatory muscle conditions and to assess disease progression
Normal Range
- Normal aldolase levels: 1.0 to 7.5 U/L (units per liter) in most laboratories
- Normal values may vary slightly between laboratories based on their reference ranges and methodology used
- Results are typically reported in U/L (units per liter) or sometimes as IU/L (international units per liter)
- Normal/Negative: Aldolase within the laboratory's established reference range indicates no evidence of significant muscle or liver cell damage
- Elevated/Abnormal: Levels above 7.5 U/L suggest muscle or liver tissue breakdown; the degree of elevation correlates with the severity of tissue damage
- Slightly elevated: 7.5-15 U/L (mild elevation, may warrant further investigation)
- Moderately to markedly elevated: >15 U/L (significant elevation suggesting substantial tissue damage or active disease process)
Interpretation
- Mild Elevation (1.5 to 3 times normal): May indicate early-stage muscle disease, mild liver injury, hemolysis, or recent minor muscle trauma
- Moderate Elevation (3 to 10 times normal): Suggests active myositis, muscular dystrophy, acute hepatitis, or significant muscle injury
- Marked Elevation (>10 times normal): Indicates severe muscle disease, rhabdomyolysis, acute severe hepatitis, or extensive tissue damage
- Progressive Elevation Over Time: May indicate worsening disease or inadequate treatment response
- Declining Elevation Over Time: May indicate disease stabilization, treatment response, or recovery from acute injury
- Factors Affecting Results:
- Recent strenuous exercise or muscle trauma can elevate aldolase levels
- Hemolysis (red blood cell breakdown) during blood draw can cause falsely elevated results
- Pregnancy and certain medications may affect aldolase levels
- Age, sex, and body composition may influence baseline aldolase levels
- Timing of sample collection relative to acute muscle injury affects interpretation
Associated Organs
- Primary Organ Systems:
- Skeletal muscle system - primary source of aldolase elevation in muscle diseases
- Hepatic (liver) system - significant aldolase source in liver disease
- Muscle Diseases Associated with Elevated Aldolase:
- Muscular dystrophies (Duchenne, Becker, limb-girdle, and facioscapulohumeral types)
- Inflammatory myopathies: dermatomyositis, polymyositis, and inclusion body myositis
- Rhabdomyolysis - massive muscle breakdown causing severe elevation
- Glycogen storage diseases (especially types II, III, IV, and V)
- Mitochondrial myopathies
- Liver Conditions Associated with Elevated Aldolase:
- Acute hepatitis (viral, autoimmune, or drug-induced)
- Cirrhosis and chronic liver disease
- Hepatocellular carcinoma and other liver tumors
- Liver necrosis and fulminant hepatic failure
- Other Conditions:
- Acute myocardial infarction (heart attack) - cardiac muscle damage
- Severe hemolysis causing release of red blood cell aldolase
- Sepsis and severe systemic infections affecting multiple organ systems
- Associated Complications and Risks:
- Muscle disease progression may lead to weakness, mobility loss, and respiratory compromise
- Severe muscle injury can cause myoglobinuria leading to acute kidney injury
- Uncontrolled liver disease progression may result in hepatic failure and cirrhotic complications
Follow-up Tests
- For Suspected Muscle Disease:
- Creatine kinase (CK) and CK-MB - more specific muscle damage markers
- Lactate dehydrogenase (LDH) - another tissue damage enzyme marker
- Myoglobin - indicates severe muscle breakdown, especially rhabdomyolysis
- Electromyography (EMG) - assesses muscle electrical activity and function
- Muscle biopsy - confirms diagnosis of myositis or muscular dystrophy
- Genetic testing - if hereditary muscle disease is suspected
- Autoantibody panels - for dermatomyositis, polymyositis (anti-Jo-1, anti-Mi-2, etc.)
- For Suspected Liver Disease:
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) - liver enzymes
- Alkaline phosphatase and gamma-glutamyl transferase (GGT) - cholestasis markers
- Total and direct bilirubin - assess liver function and cholestasis
- Albumin and prothrombin time (PT/INR) - assess synthetic liver function
- Viral hepatitis serology (Hepatitis A, B, C antibodies and antigens)
- Hepatic ultrasound or CT imaging - visualize liver structure and pathology
- Liver biopsy - when imaging results are inconclusive or cirrhosis is suspected
- For Rhabdomyolysis or Severe Muscle Injury:
- Serum creatinine and blood urea nitrogen (BUN) - assess kidney function
- Urinalysis with myoglobin - detect myoglobinuria and kidney involvement
- Electrolytes (sodium, potassium, calcium, phosphate) - monitor for dangerous imbalances
- Monitoring Frequency:
- Acute conditions: May repeat aldolase every 24-48 hours to monitor progression or recovery
- Chronic muscle disease: Typically monitored monthly to quarterly depending on treatment response
- Liver disease: Monitoring intervals vary from weekly in acute cases to annually in stable chronic disease
Fasting Required?
- Fasting: No - fasting is NOT required for aldolase testing
- Blood can be drawn at any time of day regardless of meal intake
- Patient Preparation Instructions:
- Avoid strenuous exercise or heavy exertion for 24 hours prior to testing if possible, as this can elevate aldolase levels
- Inform the healthcare provider of any recent muscle injuries or trauma
- Wear comfortable clothing that allows easy access to the arm for blood draw
- Medications:
- Continue taking all regularly prescribed medications unless specifically instructed otherwise by the physician
- Inform the healthcare provider of any medications, supplements, or herbal products being taken, as some may affect results
- Corticosteroids, statins, and certain anticonvulsants may influence aldolase levels
- Timing Considerations:
- For acute conditions, blood should be drawn as soon as possible after symptom onset when aldolase levels are highest
- For chronic monitoring, consistent sampling time (morning) may improve result comparability
- Special Circumstances:
- If multiple laboratory tests are being performed at the same time, only one blood draw is typically needed
- Report any excessive bleeding or bruising at the puncture site to healthcare personnel
- Sample should be processed promptly to prevent hemolysis which can falsely elevate results

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