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                                               Alkaline Phosphatase (ALP)
Acanthamoeba Keratitis
Acetaminophen
Acetylcholine Receptor Antibody                Alkaline phosphatase refers to a family of enzymes that catalyze hydrolysis of phosphate esters
Acetylsalicylic Acid                           at an alkaline pH. ALP is present (in decreasing order of abundance) in placenta, intestine,
Acid Phosphatase                               kidney, bone and liver. In adults, more than 80% of serum ALP activity derives from liver and
ACTH                                           bone. In late pregnancy, placental ALP is increased. In children and adolescents most serum
ACTH Rapid Stimulation Test                    ALP activity originates in osteoblasts and correlates with the rate of bone growth. The serum
Activated Clotting Time                        half life is seven days.
Activated Protein C Resistance
Adrenal Insufficiency
                                                       Hepatitis B Screenings                             Diagnosed with Leukaemia?
Aging Effect on Laboratory Values                      A blood test can diagnosis Hepatitis. Learn more   University researched guide for patients and
Alanine Aminotransferase                               now.                                               families. Order Here
Albumin                                                HepatitisInfo org                                  www ipp-shr cqu edu au/bookshop/
Alcohol
Alcohol Urine
Aldosterone
Alkaline Phosphatase                           Several caveats must be remembered in interpreting ALP results.
Allergic Bronchopulmonary Aspergillosis
Allergy Workup                                         ALP levels should always be measured after fasting because enzyme levels increase as
Alpha 1 Antitrypsin                                    much as 30 U/L after food ingestion. Patients with blood group O and B who are
Alpha Fetoprotein Maternal Serum                       secretors can have increased ALP levels after eating a fatty meal because of the release
Alpha Fetoprotein Tumor Marker                         of intestinal enzyme.
AML Blast Clearance                                    African Americans have 10 to 15% higher ALP serum levels than Caucasians.
Ammonia                                                In children, ALP is increased up to 3 times the upper limit of normal and in pregnant
Amniotic Fluid Optical Density                         patients it can be increased up to 2 times normal.
Amylase                                                ALP levels may double following bone fracture.
Amyloidosis                                            Smokers have 10% higher ALP levels than nonsmokers do.
Amyloid Precursor Protein                              ALP levels fluctuate approximately 6% from week to week in a healthy individual.
Anaerobe Bacterial Culture
Angiotensin Converting Enzyme                  ALP is most useful in diagnosing cholestatic liver diseases. Bile duct obstruction results in
Anion Gap                                      increased synthesis of ALP by bile duct epithelial cells and release of ALP into the serum.
Anthrax                                        Alkaline phosphatase may be increased even if only a few small bile ducts are obstructed and
Anti-Hu Antibody                               serum bilirubin is normal. Serum ALP often exceeds four times the upper limit of normal in
Anti-IgA Antibody                              extrahepatic and intrahepatic cholestasis. The most common causes of extrahepatic cholestasis
Anti-beta-2-glycoprotein I Antibody            are pancreatic cancer, common duct stones and strictures, and primary sclerosing cholangitis.
Antibody Screen                                Intrahepatic cholestasis is usually due to primary biliary cirrhosis or drug reactions
Anticardiolipin Antibody                       (erythromycin, chlorpromazine, estrogens, and methyltestosterone). Patients with primary
Anticoagulants                                 sclerosing cholangitis and primary biliary cirrhosis initially have elevated ALP and normal
Antidiuretic Hormone                           bilirubin levels.
Antifactor Xa LMW Heparin
Antimicrobial Susceptibility Testing
Antineutrophil Cytoplasmic Antibody
Antinuclear Antibodies
Antiphospholipid Antibody Syndrome                     www.XCell-Center.com/Treatm_Results                                                     Ads by Google
Anti-Ri Antibody
Antistreptolysin O
Antithrombin                                   When the ALP level is increased disproportionately to the bilirubin level (e.g. a bilirubin < 1.0
Arenavirus                                     mg/dL and ALP > 1000 U/L), granulomatous or infiltrative diseases of the liver are likely.
Arterial Blood Gas                             Possible diagnoses include sarcoidosis, fungal infections, tuberculosis, and lymphoma. ALP
Arterial Thrombosis Laboratory Testing         levels are also increased in hyperthyroidism, cardiac failure, lymphoma, and hypernephroma.
Aspartate Aminotransferase
Atherogenic Dyslipidemia                       Lower ALP levels (< 3 times the upper limit of normal) are less specific for cholestatic liver
                                               disease and may be seen with hepatocellular diseases such as acute viral hepatitis, chronic
                                               hepatitis, and cirrhosis. However, it is important to remember that incomplete obstruction by
                                               gallstones may produce mildly elevated ALP levels. Intrahepatic cholestasis secondary to
                                               anabolic steroids or birth control pills may cause mild increases in ALP. Gamma
                                               glutamyltransferase (GGT) can be measured to determine if elevated ALP levels are of liver
                                               origin; increased GGT indicates that ALP is most likely from the liver.

                                               Medications that have been reported to increase ALP include; allopurinol, anabolic steroids,
                                               captopril, carbamazepine, chlorpromazine, chlorpropamide, diltiazem, erythromycin, estrogens,
                                               flutamide, gold salts, methimazole, methyltestosterone, phenothiazines, phenylbutazone,
                                               phenytoin, quinidine, sulfonamides, tolazamide, tolbutamide, trimethoprim-sulfamethoxazole,
                                               valproic acid, and verapamil.
Sometimes it is useful to look at the relationship of ALP to bilirubin and lactate dehydrogenase
                             (LD) levels.


                                                    Pathology                       ALP            Bilirubin            LD

                                  Intra or extrahepatic cholestasis            Increased        Increased       Normal

                                  Focal benign cholestasis                     Increased        Normal          Normal

                                  Focal malignant cholestasis                  Increased        Normal          Increased



                             Osteoblastic bone disease can also increase serum ALP. The most common bone disorders
                             associated with elevated ALP are; Paget's disease, osteomalacia, hyperparathyroidism,
                             osteogenic sarcoma, and bone metastases.

                             Low alkaline phosphatase levels have been reported in patients with magnesium deficiency,
                             hypothyroidism, malnutrition, hemolytic anemia, Wilson's Disease, post coronary bypass
                             surgery, estrogen replacement therapy, and congenital hypophosphatasia. Blood transfusion
                             causes transient decreases in ALP, due to chelation of cations by citrate.

                             Reference range in adults is 40 - 125 IU/L (Vitros Analyzer).

                             Specimen requirement is one SST tube of blood. If blood is collected in a citrate or EDTA tube,
                             ALP activity will be almost totally inhibited due to the chelation of zinc and magnesium, which
                             are necessary enzyme cofactors.




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47 Alkaline Phosphatase (Alp) Clin Lab Navigator.Com

  • 1. Buy Our Book | Home | Contact Us | Links Test Interpretations Transfusion Quality Control Utilization Method Evaluation Test Significant Change Q&A Blog Alkaline Phosphatase (ALP) Acanthamoeba Keratitis Acetaminophen Acetylcholine Receptor Antibody Alkaline phosphatase refers to a family of enzymes that catalyze hydrolysis of phosphate esters Acetylsalicylic Acid at an alkaline pH. ALP is present (in decreasing order of abundance) in placenta, intestine, Acid Phosphatase kidney, bone and liver. In adults, more than 80% of serum ALP activity derives from liver and ACTH bone. In late pregnancy, placental ALP is increased. In children and adolescents most serum ACTH Rapid Stimulation Test ALP activity originates in osteoblasts and correlates with the rate of bone growth. The serum Activated Clotting Time half life is seven days. Activated Protein C Resistance Adrenal Insufficiency Hepatitis B Screenings Diagnosed with Leukaemia? Aging Effect on Laboratory Values A blood test can diagnosis Hepatitis. Learn more University researched guide for patients and Alanine Aminotransferase now. families. Order Here Albumin HepatitisInfo org www ipp-shr cqu edu au/bookshop/ Alcohol Alcohol Urine Aldosterone Alkaline Phosphatase Several caveats must be remembered in interpreting ALP results. Allergic Bronchopulmonary Aspergillosis Allergy Workup ALP levels should always be measured after fasting because enzyme levels increase as Alpha 1 Antitrypsin much as 30 U/L after food ingestion. Patients with blood group O and B who are Alpha Fetoprotein Maternal Serum secretors can have increased ALP levels after eating a fatty meal because of the release Alpha Fetoprotein Tumor Marker of intestinal enzyme. AML Blast Clearance African Americans have 10 to 15% higher ALP serum levels than Caucasians. Ammonia In children, ALP is increased up to 3 times the upper limit of normal and in pregnant Amniotic Fluid Optical Density patients it can be increased up to 2 times normal. Amylase ALP levels may double following bone fracture. Amyloidosis Smokers have 10% higher ALP levels than nonsmokers do. Amyloid Precursor Protein ALP levels fluctuate approximately 6% from week to week in a healthy individual. Anaerobe Bacterial Culture Angiotensin Converting Enzyme ALP is most useful in diagnosing cholestatic liver diseases. Bile duct obstruction results in Anion Gap increased synthesis of ALP by bile duct epithelial cells and release of ALP into the serum. Anthrax Alkaline phosphatase may be increased even if only a few small bile ducts are obstructed and Anti-Hu Antibody serum bilirubin is normal. Serum ALP often exceeds four times the upper limit of normal in Anti-IgA Antibody extrahepatic and intrahepatic cholestasis. The most common causes of extrahepatic cholestasis Anti-beta-2-glycoprotein I Antibody are pancreatic cancer, common duct stones and strictures, and primary sclerosing cholangitis. Antibody Screen Intrahepatic cholestasis is usually due to primary biliary cirrhosis or drug reactions Anticardiolipin Antibody (erythromycin, chlorpromazine, estrogens, and methyltestosterone). Patients with primary Anticoagulants sclerosing cholangitis and primary biliary cirrhosis initially have elevated ALP and normal Antidiuretic Hormone bilirubin levels. Antifactor Xa LMW Heparin Antimicrobial Susceptibility Testing Antineutrophil Cytoplasmic Antibody Antinuclear Antibodies Antiphospholipid Antibody Syndrome www.XCell-Center.com/Treatm_Results Ads by Google Anti-Ri Antibody Antistreptolysin O Antithrombin When the ALP level is increased disproportionately to the bilirubin level (e.g. a bilirubin < 1.0 Arenavirus mg/dL and ALP > 1000 U/L), granulomatous or infiltrative diseases of the liver are likely. Arterial Blood Gas Possible diagnoses include sarcoidosis, fungal infections, tuberculosis, and lymphoma. ALP Arterial Thrombosis Laboratory Testing levels are also increased in hyperthyroidism, cardiac failure, lymphoma, and hypernephroma. Aspartate Aminotransferase Atherogenic Dyslipidemia Lower ALP levels (< 3 times the upper limit of normal) are less specific for cholestatic liver disease and may be seen with hepatocellular diseases such as acute viral hepatitis, chronic hepatitis, and cirrhosis. However, it is important to remember that incomplete obstruction by gallstones may produce mildly elevated ALP levels. Intrahepatic cholestasis secondary to anabolic steroids or birth control pills may cause mild increases in ALP. Gamma glutamyltransferase (GGT) can be measured to determine if elevated ALP levels are of liver origin; increased GGT indicates that ALP is most likely from the liver. Medications that have been reported to increase ALP include; allopurinol, anabolic steroids, captopril, carbamazepine, chlorpromazine, chlorpropamide, diltiazem, erythromycin, estrogens, flutamide, gold salts, methimazole, methyltestosterone, phenothiazines, phenylbutazone, phenytoin, quinidine, sulfonamides, tolazamide, tolbutamide, trimethoprim-sulfamethoxazole, valproic acid, and verapamil.
  • 2. Sometimes it is useful to look at the relationship of ALP to bilirubin and lactate dehydrogenase (LD) levels. Pathology ALP Bilirubin LD Intra or extrahepatic cholestasis Increased Increased Normal Focal benign cholestasis Increased Normal Normal Focal malignant cholestasis Increased Normal Increased Osteoblastic bone disease can also increase serum ALP. The most common bone disorders associated with elevated ALP are; Paget's disease, osteomalacia, hyperparathyroidism, osteogenic sarcoma, and bone metastases. Low alkaline phosphatase levels have been reported in patients with magnesium deficiency, hypothyroidism, malnutrition, hemolytic anemia, Wilson's Disease, post coronary bypass surgery, estrogen replacement therapy, and congenital hypophosphatasia. Blood transfusion causes transient decreases in ALP, due to chelation of cations by citrate. Reference range in adults is 40 - 125 IU/L (Vitros Analyzer). Specimen requirement is one SST tube of blood. If blood is collected in a citrate or EDTA tube, ALP activity will be almost totally inhibited due to the chelation of zinc and magnesium, which are necessary enzyme cofactors. Advertise | Biography | Terms of Use | Privacy Policy | Site Map | Copyright © 2006 - 2009 by ClinLab Navigator, LLC.