 |
 |
Many thanks to those who replied to this topic. My grandson was born with an aortic atresia and had 3 heart operations in his first 2 years of life. About two years ago he developed a protein losing enteropathy – some of you may recall I asked if anyone had a special interest in PLE at that time. This is a recognised complication (1). He has responded to steroids and sildenafil helps him to maintain good albumin levels – he goes back on steroids if the levels fall in response to colds etc. The results for a series of these patients has been published recently (2) and they show that alkaline phosphatise levels may also fall along with the albumin levels. It is suggested that this reflects a low cardiac output and that it may be an early indicator of reduced bone growth. My grandson will be 9 this year and is about the 10th centile for growth - hence the interest. More recently, a paper has been published (3) concerning the role of alkaline phosphatise in colitis and a link between low levels of alkaline phosphatase and inflammatory bowel disease. When my son, who works in Nuclear Medicine in Kent, found this paper, he phoned me to ask about the clinical significance of low alkaline phosphatise levels and if it is possible that the drop in enzyme is causing or exacerbating protein loss. Now I've recently retired after 40 years in Clinical Chemistry and I had to admit that I have really paid little attention to low alkaline phosphatase levels for most of that time and I wondered if this was typical of the rest of the profession. So, now you have the full story. Regards Elliott 1. J Rychik,’ Protein-Losing Enteropathy after Fontan Operation’ Congenit Heart Dis.(2007);2:288–30 2. A J Chin, P Stephens, E Goldmuntz, M B Leonard, ’ Serum Alkaline Phosphatase Reflects Post-Fontan Hemodynamics in Children ‘ Pediatr Cardiol (2009) 30:138–145 3. A Tuin, K Poelstra, A de Jager-Krikken, L Bok, W Raaben, M P Velders, G Dijkstra, ‘Role of alkaline phosphatase in colitis in man and rats’ Gut (2009);58:379–387. *********************************************************************** This message may contain confidential and privileged information. If you are not the intended recipient you should not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents. To do so is strictly prohibited and may be unlawful. Please inform the sender that this message has gone astray before deleting it. Thank you. 2008 marks the 60th anniversary of the NHS. It's an opportunity to pay tribute to the NHS staff and volunteers who help shape the service, and celebrate their achievements. If you work for the NHS and would like an NHSmail email account, go to: www.connectingforhealth.nhs.uk/nhsmail ***********************************************************************