Elevated alkaline phosphatase

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Elevated alkaline phosphatase
Classification and external resources
Feathery degeneration high mag.jpg
Micrograph showing changes that may be associated with an elevated alkaline phosphatase (cholestasis and feathery degeneration). Liver biopsy. H&E stain.
ICD-10 R74.8
ICD-9 790.5

Elevated alkaline phosphatase describes the situation where the levels of alkaline phosphatase exceed the reference range. It can be associated with certain medical conditions.[1] or syndromes (e.g., hyperphosphatasia with mental retardation syndrome, HPMRS)

If it is unclear why alkaline phosphatase is elevated, isoenzyme studies using electrophoresis can confirm the source of the ALP. Heat stability also distinguishes bone and liver isoenzymes ("bone burns, liver lasts").



Other unlisted musculoskeletal conditions may also cause elevated alkaline phosphatase.


As carcino-placental alkaline phosphatase (Reagan's isoenzyme)



  1. ^ Li-Fern H, Rajasoorya C (February 1999). "The elevated serum alkaline phosphatase--the chase that led to two endocrinopathies and one possible unifying diagnosis". Eur. J. Endocrinol. 140 (2): 143–7. doi:10.1530/eje.0.1400143. PMID 10069658. 
  2. ^ Gennari L, Di Stefano M, Merlotti D, et al. (October 2005). "Prevalence of Paget's disease of bone in Italy" ([dead link]). J. Bone Miner. Res. 20 (10): 1845–50. doi:10.1359/JBMR.050518. PMID 16160742. 
  3. ^ Lange PH, Millan JL, Stigbrand T, Vessella RL, Ruoslahti E, Fishman WH (August 1982). "Placental alkaline phosphatase as a tumor marker for seminoma". Cancer Res. 42 (8): 3244–7. PMID 7093962. 
  4. ^ L Tibi, A W Patrick, P Leslie, A D Toft and A F Smith (1989-07-01). "Alkaline phosphatase isoenzymes in plasma in hyperthyroidism". Clinchem.org. Retrieved 2014-07-03. 
  5. ^ Pruessner, Harold T, “Detecting Celiac Disease in your Patients” American Family Physician: 57 (5), March 1 1998 pp1023-1034.
  6. ^ Eur J Gastroenterol Hepatol. 2012 Jan;24(1):17-24. doi: 10.1097/MEG.0b013e32834c7b71. Liver-test abnormalities in sarcoidosis. Cremers J, Drent M, Driessen A, Nieman F, Wijnen P, Baughman R, Koek G.
  7. ^ Pareek, S. S., “Liver involvement in secondary syphilis” Digestive Diseases and Sciences: 24 (1), January 1979 pp41-43.

External links[edit]