[Hemolytic Anemia with Excessively Elevated Lactic Dehydrogenase Levels].

ABSTRACT

It has become easier to acquire patients' clinical information from clinical laboratories using the electronic medical record system. However, it is possible that clinical laboratories do not consider abnormal laboratory data when elucidating the pathological mechanism of diseases in patients when their clinical information is obtained from the electronic medical records. In this reversed clinicopathological conference, we analyzed the laboratory data of a patient with elevated lactate dehydrogenase (LD) levels and anemia. Although the presence of hemolysis was clear from the elevated LD levels, anemia, and decreased haptoglobin levels, the ,excessive increase in the LD level suggested a particular mechanism of hemolysis. Drug intake was sus- pected on the basis of a prolonged prothrombin time with a normal activated partial thromboplastin time. At the conference, these findings led to in-depth discussions. We elucidated the pathological mechanism in this patient based only on the laboratory data, with intentionally restricted clinical information, and again recog- nized the importance of analyzing laboratory data thoroughly. Training modules for medical technologists and doctors in clinical laboratories that provide information regarding elucidating pathological mechanisms using laboratory data may prove useful for improving the nature of comments in laboratory data reports. In addition, clinicians should also receive training to elucidate the pathological mechanism of a disease on the basis of only laboratory data, as well as training for diagnosing patients on the basis of clinical information and physical examination findings. [Review].