Elevated alkaline phosphatase

Introduction Alkaline phosphatase (ALP or AKP) is an enzyme that is widely distributed in the liver, bones, intestines, kidneys, and placenta. This enzyme catalyzes the removal of the 5' phosphate group from the nucleic acid molecule, thereby converting the 5'-P terminus of the DNA or RNA fragment to the 5'-OH terminus. But it is not a single enzyme, but a group of isozymes. Six isozymes of AKP1, AKP2, AKP3, AKP4, AKP5 and AKP6 have been discovered. Among them, the first, second, and sixth are from the liver, the third is from the bone cells, the fourth is from the placenta and cancer cells, and the fifth is from the intestinal villus epithelium and fibroblasts. Alkaline phosphatase is mainly used for the examination of obstructive jaundice, primary liver cancer, secondary liver cancer, and cholestatic hepatitis. In the case of these diseases, hepatocytes overproduce ALP, enter the bloodstream through the lymphatic and sinusoids, and at the same time, due to intrahepatic biliary biliary excretion disorders, the reverse flow of blood causes a significant increase in serum alkaline phosphatase.

Cause

Hepatocytes overproduce ALP, enter the blood through the lymphatic and hepatic sinus, and at the same time, due to intrahepatic biliary biliary excretion disorder, the reverse flow of blood causes a significant increase in serum alkaline phosphatase.

1. Physiological reasons Children's skeletal development, pregnant women, and fracture healing period. Under these conditions, alkaline phosphatase in bone tissue is very active, so the detection value will be high.

2, pathological reasons When the human body has obstructive jaundice, primary liver cancer, secondary liver cancer, cholestatic hepatitis, etc., stem cells over-produce ALP, enter the blood through the lymphatic and hepatic sinus, and due to bile excretion disorders, Reversed into the blood, causing high alkaline phosphatase in the serum.

3. When the bone is sick, such as rickets, bone tumors, rickets, etc.

4. Other diseases that are not very common, such as kidney disease, severe anemia, thyroid insufficiency, leukemia, etc.

an examination

Related inspection

Renal function test alkaline phosphatase staining CT examination

Increased alkaline phosphatase often aids early diagnosis before bone signs and X-ray changes. A comprehensive examination is needed to find out the cause of the increase in alkaline phosphatase, such as five tests for hepatitis B, hepatitis A, hepatitis C check, liver and gallbladder B-ultrasound, CT examination, trace element examination, whole body bone scan, renal function test, thyroid examination, Blood tests, bone marrow tests, etc., to determine the cause.

Differential diagnosis

Increased alkaline phosphatase often aids early diagnosis before bone signs and X-ray changes. Pregnant women, fracture healing, osteomalacia. When rickets, osteoblasts, osteoporosis, liver abscess, liver tuberculosis, cirrhosis, leukemia, hyperthyroidism, serum alkaline phosphatase can also be elevated, should be identified. Women in the normal range, less than 500U/L in 1-12 years old; 40-150U/L in ages older than 15 years;
Male, 1-12 years old is less than 500U/L; 12-15 years old, less than 750U/L; more than 15 years old, 40-150U/L.
Exceeding normal values suggests that alkaline phosphatase is too high.

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