Increased alpha-hydroxybutyrate dehydrogenase in serum from children with measles.

For treatment and prognostic evaluation of patients with measles, it is important to determine the source of the increase in serum alpha-hydroxybutyrate dehydrogenase (HBD; EC 1.1.99.6). Here we measured HBD and L-lactate dehydrogenase (LD; 1.1.1.27) activities in the serum of 18 children with measles and in 18 age-matched control patients with bronchopneumonia. HBD and LD activities in the measles patients were significantly higher than those in control subjects (P less than 0.001). The HBD/LD ratio in the measles patients two to three days after the onset of rash was significantly lower than that in control subjects (P less than 0.001). The low HBD/LD ratio was similar to the ratio found in lymphocytes. The number of peripheral lymphocytes decreased markedly after the onset of rash. Our results suggest that increased serum HBD and LD activity is common in measles infection and that the increase originates from the destruction of infected lymphocytes rather than from myocardiac injury.