- It is done on the Serum of the patient.
- Patients should fast for 8 hours before giving the sample.
- Take 3 to 5 ml of blood in the disposable syringe. Keep the syringe for 15 to 30 minutes and then centrifuge for 2 to 4 minutes. Can get a clear serum.
- Avoid hemolysis and separate serum immediately.
- It is stable for:
- 8 hours at room temperature.
- 4 °C for 5 days.
- -15 °C for 15 days.
- The previous muscular injection may increase the aldolase level.
- Drugs that are hepatotoxic may increase the level.
- The phenothiazine may decrease the aldolase level.
- This test is indicated when the inflammatory diseases of the muscles (myopathy) suspected.
- To assess the severity of the myopathy.
- Other tests like Lactate dehydrogenase, Creatinine Phosphokinase, and Aspartate transferase are advised and are helpful for the diagnosis, So this test is not recommended.
- Aldolase is present in all tissue like the brain, kidneys and prominent in skeletal and heart muscles.
- Aldolase enzyme is present in the cell and in the nucleus.
- It converts sugar to energy.
- This is a glycolytic enzyme and it cleaves fructose 1,6 – bisphosphate into dihydroxyacetone phosphate and glyceraldehyde 3 – phosphate.
- This has the main interest in the primary disease of skeletal muscles.
- Clinical significance: This is greatly increased in the Duchenne-type pseudohypertrophic muscle dystrophy in contrast to other muscular diseases.
- It is high in the early stage.
- But it falls as the disease progresses.
- There is a 10 to 15 times increase than the normal level.
- This is raised in the dermatomyositis and limb-girdle dystrophy.
- Normal values are seen in poliomyelitis, myasthenia gravis, and multiple sclerosis where the origin of the muscle disease is neurogenic.
- It is usually normal in the cirrhosis and obstructive jaundice.
- Aldolase pattern is like ALT and it comes to normal in 10 to 15 days.
- Adult = 1.0 to 7.5 U /L
- Newborn = 4 X adult level
- Values are double in early childhood and then fall to a normal level slowly by the 18 to 20 years of age.
- Children 10 to 24 months = 3.4 to 11.8 U/L
- child 25 months to 16 years = 1.2 to 8.8 U/L
- Another source
- Adult = 22 to 59 mU/L at 37 °C
- Child = Approximately 2 times the adult value.
- Newborn = Approximately 4 times the adult value.
The Aldolase level is increased in:
- Cell destruction like Acute myocardial infarction (5 to 8 times of the normal).
- Acute Hepatitis (Viral or toxic). It is raised in the early stage of viral or toxic hepatitis.
- Inflammatory diseases of muscles (Myopathy).
- Raised in skeletal muscle disease or injury.
- Raised in Muscular dystrophy.
- Carcinoma of the prostate (about 6 times of the normal).
- Myelocytic leukemia (about 6 times of the normal).
- Megaloblastic and hemolytic anemia (about 10 to 13 times of the normal).
- In neoplastic diseases like carcinomatous metastasis to liver, lung, breast, genitourinary system, melanoma, and CNS tumors.
It is Normal in:
- Neurogenic muscle atrophy.
- Cirrhosis (or maybe slightly increased).
- Obstructive jaundice (or maybe slightly increased).
Decreased Aldolase level is seen in:
- Hereditary fructose intolerance.
This test is nonspecific, so not commonly requested except for following up on muscle diseases.
- The increase in the level reflects the intensity of the disease and one can serially measure to know the effect of treatment by corticosteroids.
- CK is considered the choice of test for muscular diseases.