Re: elevated alkaline phosphatase

Posted By HFHSM.D.-ym on November 12, 1998 at 16:19:58:

In Reply to: elevated alkaline phosphatase posted by mel on November 06, 1998 at 21:30:17:






i have had an elevated alkaline phospatase (161) when tested jan. 98, and again in oct. 98..my physician has since ordered calcium and phosphorus blood levels, parathyroid hormone levels.. no results from those tests are back yet.. next week i am scheduled for an abdominal CAT..what are the implications of elevated ALP only, all other liver enzymes are fine... my only c/o is mild fatigue and occasional R upper quadrant pain, not severe..i do not drink any "hard" liquor, drink one glass of wine maybe once a month..i am on prescription antidepressants - paxil and trazadone- very low dosages and take aspirin for joint pain and stiffness as needed.. any information you could share would be helpful..
Dear Mel,
Alkaline phosphatase is an enzyme that is produced by liver and bile duct cells and can be elevated in diseases that cause impaired transport of bile (so-called cholestatic liver injury). However, alkaline phosphatase can also be produced in intestine and bone. One way to confirm that an elevated alkaline phosphatase level is secondary to a hepatobiliary problem is to obtain a blood test for gamma glutamyl transpeptidase (GGTP). If GGTP is elevated the source of alkaline phosphatase is liver. If it is in the normal range an investigation to rule out bone disease is often performed.
Cholestatic liver injury can occur secondary to gallbladder and bile duct problems. The first step is usually to obtain a transabdominal ultrasound or a CT scan to rule out gallstones and intra or extra hepatic biliary ductal dilatation. Other conditions that could be responsible for elevated alkaline phosphatase include: early hepatocellular disease, primary sclerosing cholangitis, primary biliary cirrhosis, drugs that cause cholestatic liver injury and granulomatous hepatitis. Tests that would rule out these disorders include blood test, ERCP (endoscopic retrograde cholangiopancreatography) and liver biopsy. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: alkaline phosphatase, cholestatic liver injury