Aldolase

Aldolase is an enzyme involved in glycolysis, the breakdown of glucose into pyruvate to produce energy for the cell. It’s found in high amounts in muscle tissue, liver, and certain other cell types. When there’s muscle or liver damage, aldolase can be released into the bloodstream, leading to elevated blood levels.

Elevated aldolase levels can be seen in several conditions, primarily those that involve muscle injury or inflammation. Here are some conditions where aldolase might be elevated:

  1. Muscle Disorders:
    1. Polymyositis and Dermatomyositis: Inflammatory myopathies where muscle fibers become inflamed and damaged.
    2. Muscular Dystrophies: Genetic diseases that cause progressive muscle weakness and muscle degeneration.
    3. Rhabdomyolysis: A serious condition where damaged skeletal muscle rapidly breaks down, releasing myoglobin, aldolase, and other intracellular proteins into the bloodstream.
    4. Necrotizing Autoimmune Myopathy: A rare inflammatory muscle condition characterized by rapid muscle cell death.
  2. Liver Diseases:
    1. While other liver enzymes (such as ALT, AST, ALP, and GGT) are more commonly associated with liver damage, significant liver injury can also result in increased aldolase levels.
  3. Myocardial Infarction:
    1. Aldolase can be elevated after a heart attack, though it’s not typically used as a primary diagnostic marker for this condition (troponins are the standard markers).
  4. Certain Malignancies:
    1. Some types of cancer, especially those that infiltrate the muscle, can elevate aldolase levels.
  5. Trauma:
    1. Direct injury to muscles, as might be seen in traumatic injuries or surgeries, can result in elevated aldolase levels.
  6. Systemic Lupus Erythematosus (SLE): Especially if there’s associated muscle inflammation.
  7. Infections: Certain viral and bacterial infections can lead to muscle inflammation and damage, potentially increasing aldolase levels.

It’s important to note that an elevated aldolase level is non-specific and should be interpreted in the context of the clinical scenario, physical examination findings, and other diagnostic studies. If elevated aldolase is detected, further evaluation to determine the cause is often warranted.