“Flipping effect” is ?
High-Yield Explanation
Ref. API Textbook of Medicine. Pg. 798
Lactate dehydrogenase, tetrameric enzyme with 4 subunits,
4 Subunits with 2 isoforms - H isoform (Heart) & M isoform (Muscle)
Heart & RBCs - LDH-1 (4H);
Reticuloendothelial system - LDH-2 (3H1M)
Lungs - LDH-3 (2H2M)
Kidneys, placenta, & pancreas - LDH-4 (1H3M)
Liver & striated muscle - LDH-5 (4M)
Flipping effect
Usually LDH 2 in predominant in serum & LDH 1 is predominant in heart
Higher levels of LDH 1 than LDH 2 (Flipped pattern) is suggestive of myocardial infarction