Highest elevation of LD is observed in which condition?

• A. Pernicious Anemia
• B. Myocardial Infarction
• C. Pneumonia
• D. Hepatic Failure

Answer: (A)

LDH rises when cells are damaged and released into the bloodstream. In pernicious anemia, there is markedly increased destruction of developing red cells inside the marrow (ineffective erythropoiesis with intramedullary hemolysis), leading to a very large release of LDH into the blood. This makes the LDH level reach higher values than in the other conditions listed.

In myocardial infarction, LDH does rise due to heart tissue injury, but the peak is typically not as high, and other enzymes (like CK-MB or troponin) are more specific for the heart. Hepatic failure can raise LDH because of liver cell injury, but the elevation varies and is not as dramatic as with intramedullary hemolysis. Pneumonia can cause some LDH elevation from inflammation, but again it’s usually less pronounced.

So the highest elevation of LDH is seen in pernicious anemia.