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
  
  
2.0 mL
  
0.5 mL
Note: This volume does not allow for repeat testing
  
  1. Allow sample to clot for a minimum of 30 minutes
  2. Spin
  

Gold serum separator (SST) tube

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

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 - 7 days 

Freeze/thaw cycles - stable x 3

 

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

Performance

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

Electrophoresis

Clinical and Interpretive info

  

Alkaline phosphatase

Age

Male (IU/L)

Female (IU/L)

0 – 5 days

47 - 127

47 - 127

6 – 10 days

29 - 242

29 - 242

11 – 20 days

109 - 357

109 - 357

21 – 30 days

94 - 494

94 - 494

1 – 2 months

149 - 539

149 - 539

3 – 6 months

131 - 452

131 - 452

7 – 11 months

117 - 401

117 - 401

12 mo – 6 years

158 - 369

158 - 369

7 – 12 years

150 - 409

150 - 409

13 years

156 - 435

78 - 227

14 years

114 - 375

64 - 161

15 years

88 - 279

56 - 134

16 years

74 - 207

51 - 121

17 years

63 - 161

47 - 113

18 – 20 years

51 - 125

42 - 106

>20 years

44 - 121

44 - 121

 

Liver fraction:

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



Bone fraction:

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


Intestine fraction:

Age (male) Percentage range (male)
0 – 30 days Not established
1m – 17 yrs 0 - 8%
18 - 100 yrs 0 - 18%
   
Age (female) Percentage range (female)
0 – 30 days Not established
1m – 17 yrs 0 - 8%
18 – 100 yrs 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
  
09/13/2021
  
02/11/2021