Aldolase is very similar to the enzymes Aspartate Aminotransferase (AST) and Creatine Kinase (CK). Aldolase is an enzyme used in the glycolytic breakdown of glucose. As with AST and CPK, aldolase is present in most tissues of the body. This test is most useful for identifying muscular or hepatic cellular injury or destruction. The serum aldolase level is very high in patients with muscular dystrophies, dermatomyositis, and polymyositis. Levels also are increased in patients with gangrenous processes, muscular trauma, and muscular infectious diseases (e.g., trichinosis). Elevated levels are also noted in chronic hepatitis, obstructive jaundice, and cirrhosis.
Neurologic diseases causing weakness can be differentiated from muscular causes of weakness with this test. Normal values are seen in patients with such neurologic diseases as poliomyelitis, myasthenia gravis, and multiple sclerosis. Elevated aldolase levels are seen in patients with primary muscular disorders.
Normal Aldolase Levels
Like any enzyme that plays a rule in building human skeleton, Aldolase levels are the highest in Newborns, a newborn Aldolase Level will normally be four times the Aldolase Level of an adult.
Aldolase levels will decrease as the person grows up. A child would normally have half the Aldolase Level of a newborn (double the Aldolase Level of an adult. In adults the Normal Aldolase Levels range between 3.0 to 8.2 Sibley-Lehninger units/dL or 22 to 59 mU/L at 37° C (SI units).
Causes of Aldolase Levels False Indications
- Previous intramuscular (IM) injections may cause High Aldolase Levels.
- Strenuous Exercise can cause a transient spike in Aldolase.
- Drugs that may cause High Aldolase Levels include Hepatotoxic Agents.
- Drugs that may cause Low Aldolase levels include Phenothiazine.
Causes of High Aldolase Levels False Indications
- Muscular Dystrophy: Highest Aldolase Levels are associated with Duchenne Muscular Dystrophy.
Disease of or injury to muscle causes lysis of the muscle cells. Intracellular enzymes such as aldolase spill out into the bloodstream and are detected at elevated levels. High Aldolase Levels that associate with Muscle Injury can be caused by:
- Muscular Trauma including Severe Crush Injuries, Muscular Infections (e.g., Trichinosis), Delirium Tremens, and Severe Burns.
- Gangrenous/Ischemic Processes (such as Prolonged Shock).
Diseases of the liver cause lysis of the liver cells. Intracellular enzymes such as Aldolase spill out into the bloodstream and are detected at elevated levels. Hepatitis, and Cirrhosis are liver diseases associated with High Aldolase Levels.
Infarction of heart muscle causes lysis of the muscle cells. Intracellular enzymes such as Aldolase spill out into the bloodstream and are detected at high levels.
Causes of Low Aldolase Levels
- As muscle mass decreases, aldolase values decrease. Low Aldolase levels can be detected in patients with Muscle Wasting Diseases or Late Muscular Dystrophy.
- Hereditary Fructose Intolerance: Without an adequate source of glycogen (i.e., Fructose), normal levels of aldolase are not needed.