Increased serum alkaline phosphatase activity

Introduction Alkaline phosphatase (ALP) is a commonly used indicator for the diagnosis of biliary tract diseases. Alkaline phosphatase is present in various tissues of the body and contains more bone, liver and kidney. Alkaline phosphatase in normal serum is mainly derived from bone, produced by osteoblasts, and excreted from the biliary system via the blood to the liver. This enzyme is significantly elevated in patients with cholestatic hepatitis and extrahepatic obstruction. ALP can only suggest biliary obstructive lesions, and it is not possible to identify whether the obstruction is benign or malignant.

Cause

The cause of increased serum alkaline phosphatase activity

1. Physiological increase: Children's alkaline phosphatase activity can be 1 to 2 times higher than that of normal people during physiological bone development.

2. Pathological elevation: 1 obstructive jaundice, cirrhosis, liver necrosis, alkaline phosphatase increased significantly (hepatocellular jaundice is not obvious). 2 Alkaline phosphatase was also significantly elevated in primary and secondary liver cancer, which was associated with increased alkaline phosphatase synthesis in cancer tissues or in hepatocytes surrounding cancer. 3 other tumors such as breast cancer, lung cancer, ovarian cancer, osteoblastoma, osteosarcoma, etc., when the alkaline phosphatase is increased, suggesting that there may be liver metastasis. 4 deformed osteitis, osteoblastic carcinoma, rickets, osteomalacia, hyperthyroidism and hyperparathyroidism, renal tubular acidosis, hereditary phosphatase hyperactivity 5 many drugs can increase alkaline phosphatase, such as Pakistan Biloba, antibiotics (erythromycin, gentamicin, chloramphenicol, kanamycin, ampicillin, etc.).

an examination

Related inspection

Serum alkaline phosphatase (ALP)

Examination of elevated serum alkaline phosphatase activity

[normal reference value]

(1) Enzyme rate method (37 ° C): Adult: 40 ~ 160U / L; Children: <350U / L;

(2) Phosphate disodium phosphate method: Adult: 3 to 13 Kat units; Children: 5 to 30 kat units;

(3) Dynamic method: Adult: 20~110U/L; Adolescent: 1. Male: <750U/L; 2. Female: <500U/L; Child: <500U/L; Infant: 50~240U/L.

[Clinical significance]: Increased in acute and chronic jaundice hepatitis, obstructive jaundice, biliary calculus, cholangiocarcinoma, liver cancer, fibrotic osteitis, sinus disease, fracture repair healing period.

Differential diagnosis

Symptoms of increased serum alkaline phosphatase activity

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. However, this enzyme is also active in bone tissue. Therefore, 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.

Simultaneous detection of ALP and transaminase contributes to the identification of jaundice. Obstructive jaundice, ALP increased significantly, while transaminase only increased slightly. Intrahepatic localized bile duct obstruction (such as liver cancer) ALP is significantly elevated, while bilirubin is not high. Hepatocyte jaundice, ALP is normal or slightly higher, and transaminase is significantly elevated. Hemolytic jaundice ALP is normal. Skeletal disease: fibrous osteitis, osteogenesis imperfecta, rickets, osteomalacia, bone metastases, and fracture repair. ALP can be used as an indicator of the efficacy of rickets.

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