High Levels of Alkaline Phosphatase

  If the "liver test" or "liver function test" indicates abnormaly high levels of Alkaline phosphatase (in a 18 month old) is that specific to the liver or could it possible be a bone related problem. ie.. is the liver test the same as the five-prime nucleotidase?
  My 18 month old had an abnormaly high level of alkaline phosphatase and the Pediatrician wants more blood work. I am concerned about my child being in the 5th % for weight and he has been relatively low % and falling since birth. Baby was to term and not a premie -but rather tall and slim like mom & Dad. Is it possible the slow to gain would be related to high levels of alkaline phosphatase? We tested for Celiac's disease(neg) hydocephallis(neg) and cyctic fibrosis(neg). The MD now wants to do gasto-intestinal exame where they shove the tube down your throat and take a sample from the small intestine... does this appear to be necessary?  I sthere any other way to test for absorption of nutrients?

[HFHS.RN-AM]

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Dear Moonmama,
I apologize for the delay in answering your question.
Alkaline Phosphatase (alk-phos) may be elevated in both liver and bone disease. The five-prime nucleutidase test is similar to the alk-phos but is specific to liver and levels are not elevated in bone disease.
Children who fail to gain weight properly are a very serious concern to parents and doctors. Assuming that the normal investigations have been done, it is reasonable to obtain a biopsy which may provide important information about your child's condition.
An intestinal biopsy does not have to be painful for your child. You may want to ask the doctor about conscious sedation, whereby the child gets "twilight sleep" for the duration of the procedure.
HFHS-RN-AM
*KEYWORD: Failure to thrive, malabsorbtion disorders, liver disease, alkaline phosphatase