title: [Case of enzyme-linked immunoglobulin with persistent elevation of lactate dehydrogenase activity in serum by administration of an anti-psychotic drug].
abstract: We presented a case, who showed extremely high activity of lactate dehydogenase (LD) and confirmed the presence of the LD linked immunoglobulin in her serum. The maximum activity of LD was 6830 IU/L, and the electrophoretic pattern of LD isozymes showed the broad spectrum from isozyme LD2 to LD5. Analysis by counter immuno electrophoresis revealed that immunogloblin was attached to the M subunit of LD and its subtype was an IgG, lambda-chain. The cause, which produced the complex, might be thought to be the side effects by tiapride administrated for her mild dementia. After discontinuance of this drug, the LD activity in serum had gradually reduced. The serum creatinine also increased gradually after administration of tiapride, and did not reverse to normal level by discontinuance of it. The patient died from acute renal failure, which aggravated from sporadic urinary tract infection. It was suggested that her basal renal dysfunction might be due to the LD IgG complexes. We propose a rapid disruption of suspicious drug for the course of the production of LD linked immunoglobulin, because very high titer of these complexes might suffer irreversible damage to the kidney, which chance to become acute renal failure.
authors.affiliation: Department of Clinical Laboratory, Fukuoka University Hospital, Fukuoka 814 0180.
authors.forename: Inako
authors.initials: I
authors.lastname: Okamoto
authors.forename: Kumiko
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Hironobu
authors.initials: H
authors.lastname: Kawashima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ideguchi
authors.forename: Junko
authors.initials: J
authors.lastname: Ono
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007146:Immunoglobulin lambda-Chains / Q000097:blood*; D007527:Isoenzymes / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D013976:Tiapamil Hydrochloride / Q000009:adverse effects*
chemical_list: D014150:Antipsychotic Agents; D007074:Immunoglobulin G; D007146:Immunoglobulin lambda-Chains; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase; D013976:Tiapamil Hydrochloride