Is this not just a transient hyperphosphataseamia I think I read a paper
where it has been associated with recent infection.
We had an adult patient here who had a renal transplant, whos ALP went
from the 500s (elevated, Bone fraction) to the 13,000s in about 2 weeks
and then reduced back down to the previous 400-500 levels.
During the transient elevatation the ALP electrophoresis pattern showed
a band anodal to the liver band which was retarded upon treatment with
neuraminidase and migrated into an area approximate to that of the bone
isoenzyme. We took this to indicate a transient form of alkaline
phosphatease isoenzyme. Scanning calculated the liver isoenzyme to be
22% of total and transient and bone to 77% of total.
Lectin electrophoresis showed a slightly "odd" pattern in that there was
considerable smearing of the sample but the lectin didn't appear to
retard the isoenzyme like we would have expected with a bone isoenzyme.
Perhaps it is the bone isoenzyme but with altered glycosylation. There
is evidence to support this in the literature "What is the cause of
benign transient hyperphosphataemia? A study of 35 cases" Crofton PM,
Clinical Chemistry, Vol 34, 335-340
The altered glycosylation of the protein for example may alter its
clearence by the liver. It appears with other proteins that the
glycosylation and synthetic pathways are not linked and so it may not
neccesarly be due to enhanced production.
Craig Webster
Principal Clinical Biochemist
Nottingham City Hospital
-----Original Message-----
From: owner-acb-clin-chem-gen [mailto:owner-acb-clin-chem-gen]
Sent: Friday, May 02, 2003 4:12 PM
To: cwebste1
Subject: Raised Alkaline phosphatase in 18 month old
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