Serum Aldolase: Overview and Significance

What is Serum Aldolase?

It's an enzyme similar to aspartate aminotransferase (AST) and creatine phosphokinase (CPK), involved in the breakdown of glucose (glycolysis). It's found in most body tissues and is used to indicate muscular or liver cell damage.

When is it High?

High levels of serum aldolase are seen in conditions like muscular dystrophies, dermatomyositis, polymyositis, gangrenous processes, muscular trauma, and infections (e.g., trichinosis). It's also elevated in chronic liver conditions like hepatitis, obstructive jaundice, and cirrhosis.

When is it "Normal"?

Normal levels are observed in neurological diseases such as poliomyelitis, myasthenia gravis, and multiple sclerosis, helping to distinguish between muscular and neurological causes of weakness.

Interfering Factors:

Previous intramuscular injections and strenuous exercise can temporarily raise aldolase levels. Certain drugs can also affect its levels; hepatotoxic agents may increase them, while phenothiazines may decrease them.

Clinical Relevance:

Increased Levels: Indicate hereditary fructose intolerance, late muscular dystrophy, muscle-wasting diseases, gangrenous processes, liver diseases, muscular diseases and infections, muscular trauma, and myocardial infarction.

Decreased Levels: These are less commonly reported and can be associated with some of the same conditions that cause increased levels, likely due to varying stages or severities of the diseases.

In summary

Serum aldolase is a crucial enzyme for diagnosing and differentiating between muscular and liver diseases, as well as distinguishing muscular disorders from neurological conditions.

Reference

Pagana, Kathleen Deska, et al. Mosby's Diagnostic and Laboratory Test Reference. 16th ed., Mosby, 2022.