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Alkaline Phosphatase
Overview
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Overview
The main indications for determination of alkaline phosphatase (ALP) are suspicion of cholestatic liver disease, bone disease and skeletal involvement of other primary diseases.
In most cases other additional tests are needed to differentiate the cause of abnormal ALP values:
Hepatobiliary diseases
In hepatobiliary diseases, ALP levels in general reflect the degree of biliary occlusion or associated cholestasis. Elevated ALP and serum
γ-glutamyltransferase (GGT) argue for cholestasis. However, the combination of high ALP and a normal GGT does not rule out liver disease completely. If other liver tests such as bilirubin,
glutamic-oxaloacetic transaminase (GOT), or
glutamic-pyruvic transaminase (GPT) are also high, it can be concluded that the ALP originates from liver. In liver disease with a cholestatic component ALP may see a much greater increase than GOT and GPT.
Bone disease
ALP levels reflect osteolytic and osteoblastic activities. If ALP is high due to bone disease, serum
γ-glutamyltransferase (GGT) will be normal. Measurement of calcium and phosphate levels provide further hints to ALP probably coming from bone.
Using Reflotron® Alkaline Phosphatase with Reflotron® Plus or Reflotron® sprint ALP enzyme activity can easily be determined in the primary care environment within minutes. These instruments provide reliable values using either whole capillary or venous blood, serum or plasma.
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