Alkaline phosphatase isoenzymes-13505

Test info

  
Alkaline phosphatase isoenzymes
  
13505
  
LAB13505
  
ALPI
  
Alk phos isoenzyme
ALP
ALP Isoenzymes
Fractionated Alkaline Phosphatase
Kasahara Isoenzymes
Nag Ao Isoenzymes
Regan Isoenzymes
  
  • Relative percentages of liver, bone, and intestinal alkaline phosphatase isoenzymes
  • Total alkaline phosphatase
  
  • Evaluate the contribution of the isoforms of ALP from liver, bone, and bowel to total ALP
  • Investigate elevations of ALP to determine the tissue of origin

Specimen

  
  • Patient should be fasting overnight
    • Patients who have B or O blood group and are secretors may have an elevated ALP about two hours after a fatty meal.
  
Serum
  
  
1.6 mL
  
0.8 mL
Submission of the minimum volume does not allow for repeat testing
  

Immediatley following collection, mix sample by gently inverting 5 times

  
  1. Allow sample to clot for a minimum of 30 minutes
  2. Spin as soon as possible after the blood is allowed to clot
  

Gold serum separator (SST) tube

  
  
  1. Allow sample to clot
  2. Spin as soon as possible after the blood is allowed to clot and centrifugation is complete
  3. Transfer serum to a Transfer vial/tube with cap - 12mL (LabCorp) labelled as "serum" 
  

Transfer vial/tube with cap - 12mL (LabCorp)

  
  • Patient's age
  • Patient's gender
  

Store serum at 2-8 °C as soon as possible after collection.

Refrigerated (preferred) - 7 days

Ambient - 7 days

Frozen - 3 months 

Freeze/thaw cycles - stable x 3

 

  
  • Patient not fasting
  • Citrate, oxalate, or EDTA anticoagulated plasma

Performance

  
LabCorp Burlington (001612): R-LC
  
Su - Fr
  
3 - 5 days
  

Electrophoresis

Clinical and Interpretive info

  

Liver fraction:

Age (male) Percentage range (male)
0 – 6 m Not established
7 m – 5 y 3 - 50%
6 – 17 y 3 – 31%
18 – 100 y 13 – 88%
   
Age (female) Percentage range (female)
0 – 6 m Not established
7 m – 5 y 3 - 51%
6 – 12 y 2 – 25%
13 – 100 yrs 18 – 85%



Bone fraction:

Age (male) Percentage range (male)
0 – 6 m Not established
7 m – 5 y 48 - 97%
6 – 17 y 67 - 97%
18 – 100 y 12 - 68%
   
Age (female) Percentage range (female)
0 – 6 m Not established
7 m – 5 y 48 - 97%
6 – 12 y 69 - 97%
13 – 100 y 14 - 68%


Intestine fraction:

Age (male) Percentage range (male)
0 – 30 d Not established
1 m – 17 y 0 - 8%
18 - 100 y 0 - 18%
   
Age (female) Percentage range (female)
0 – 30 d Not established
1 m – 17 y 0 - 8%
18 – 100 y 0 - 18%
  

Liver is the isoenzyme most frequently elevated when total ALP levels are elevated. Liver ALP increases in the blood early in liver disease before most other liver function tests show abnormalities. The wide group of conditions leading to increased liver ALP include acute hepatitis, cirrhosis, fatty liver, drug-induced liver disease, obstruction of biliary flow by carcinoma at the head of the pancreas, bile duct stricture, primary biliary cirrhosis, and metastatic carcinoma of the liver.

Bone isoenzyme is elevated as a result of increased osteo-blastic activity. This isoenzyme is normally elevated in growing children and adults over the age of 50. The highest total ALP values have been attributed to an increased bone isoenzyme level due to Paget disease or renal rickets. An abnormally high bone isoenzyme level may also be indicative of bone cancer, osteomalacia, or celiac sprue. A decreased bone ALP in children may be attributed to cretinism or to hypophosphatasia.

Intestinal alkaline phosphatase is seen normally in the serum of subjects who have B or O blood types, especially after a fatty meal. Pathologically, the band may be present in perforation of the bowel, ulcerative disease of the intestine, and faintly in liver cirrhosis. Acute infarction of the intestine will cause a release of intestinal ALP from the mucosa. Large erosive or ulcerative lesions of the stomach, duodenum or other small intestinal areas, or colon may result in an elevation of the serum ALP level. The small intestinal lesions associated with malabsorption are associated with an elevation of the serum intestinal ALP level only if there is an erosive or ulcerative mucosal lesion.

Billing

  
84075 - Total
84080 - Isoenzymes
  
Result 6768-6

Tracking

  
03/27/2019
  
12/21/2023
  
12/21/2023