-----Original Message-----
From:   Firth, Gary
Sent:   12 July 2001 12:37
To:     [log in to unmask]
Cc:     Hine, Keith
Subject:        Alkaline phosphatase in liver cholestasis

We have a 55 year old male with bilirubins consistently around 450umol/l but with normal alkaline phosphatase of around 150 (normal up to 160).

Biopsy is indicative of intrahepatic cholestasis. AST is slighly raised around 100 (up to 38) and GGT around 125(up to 49).

We have checked alk phos on dilution and there are no problems due to substrate exhaustion. I am sending samples off to Birmingham for bile acids. I am told that the urine is dark and the stools pale - although we havn't seen these in the lab yet.

Does anyone have any ideas why alk phos might be normal in this case?