Paget's Disease

Is a number higher for 2 yrs than the highest
number for alkaline phosphatase, ceiling is 136,
my number is 142 this year possible Paget's
disease or bone cancer?  I now have scoliosis,
severe degeneration in the neck, some disks
bulging, lumbar spine: bone appears demineralized, thoracic spine: multilevel spondylosis, lumbar spine: multilevel spondylolisthesis with facet arthropathy with
pain 24 - 7.   This seems to be getting worse
each day.  I have had Idiopathis Erythrocytosis
for 14 yrs. phlebotomies only.

[S. Kaul, MD]

Hi there!

The normal range of ALP levels is 20 to 140 IU/L. ALP is normally higher in pregnancy and children. Levels at the higher end or slightly higher than normal could occur due to a number of causes including bone issues, liver causes etc. Slightly elevated levels are unlikely to be due to Pagets or cancer as these usually present with grossly elevated levels. Further investigations such as isoenzyme electrophoresis may be required to distinguish between the possible causes along with other tests. I would suggest discussing the situation and the appropriate investigation and management plan with your treating doctor.
Hope this helps.

Take care!