Elevated alkaline phosphatase
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| Elevated alkaline phosphatase | |
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| Classification and external resources | |
 Micrograph showing changes that may be associated with an elevated alkaline phosphatase (cholestasis and feathery degeneration). Liver biopsy. H&E stain. |
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| ICD-10 | R74.8 |
| ICD-9 | 790.5 |
Elevated alkaline phosphatase is a condition where the levels of alkaline phosphatase exceed that found in a 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").
Contents |
[edit] Liver
- Liver (Liver ALP):
[edit] Bone/skeletal
- Bone disease (Bone ALP):
- Paget's disease,[2] osteosarcoma, bone metastases of prostatic cancer (High / very high ALP values)
- Other bone metastases
- Renal osteodystrophy
- Fractured bone
- Multiple myeloma (only when associated with fractures)
- Skeletal involvement of other primary diseases:
- Osteomalacia, rickets, vitamin D deficiency, (Moderate rise)
- Malignant tumors (ALP originating from tumor)
- Renal disease (secondary hyperparathyroidism)
- Primary hypothyroidism
and many more causes
[edit] Cancer
As carcino-placental alkaline phosphatase (Reagan's isoenzyme)
[edit] Other
- Lung cancer
- Chlorpropamide therapy
- Infectious mononucleosis
- Pancreatic carcinoma
- Polycythemia vera
- Myelofibrosis
- Leukemoid reaction to infection
- Women using hormonal contraception
- Pregnancy
- Transient hyperphosphatasaemia of infancy: benign, often associated with infection
- Seminoma[3]
- Hyperthyroidism [4]
[edit] References
- ^ 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. http://eje-online.org/cgi/pmidlookup?view=long&pmid=10069658.
- ^ 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. http://www.jbmronline.com/doi/abs/10.1359/JBMR.050518?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov.
- ^ 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. http://cancerres.aacrjournals.org/cgi/pmidlookup?view=long&pmid=7093962.
- ^ http://www.clinchem.org/content/35/7/1427.abstract
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