Newcastle Laboratories

Alkaline phosphatase isoenzymes (typing), serum

Clinical Background:

Human alkaline phosphatase enzyme is part of a group of enzymes (phosphoric monoester hydrolases) that catalyse the hydrolysis and transfer of a phosphate group at alkaline pH. While routinely incl...

Human alkaline phosphatase enzyme is part of a group of enzymes (phosphoric monoester hydrolases) that catalyse the hydrolysis and transfer of a phosphate group at alkaline pH. While routinely included in the liver profile, it is found in many human tissues, e.g. liver, bone, kidney, intestine and placenta and may be elevated in a variety of hepatic and non-hepatic conditions as well as in normal adolescent growth. These isoenzymes can be separated by electrophoresis due to their differences in charge and sialation pattern.

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Test Details

  • Discipline:

    Biochemistry

    Biochemistry

  • Specimen Container Adult:

    Serum

    Serum

  • Specimen Container Paediatric:

    Serum

    Serum

  • Minimum Volume Adult:

    0.5 mL

    0.5 mL

  • Minimum Volume Paediatric:

    0.5 mL

    0.5 mL

  • Quality Assurance:

    Sample exchange with other Clinical Laboratories

    Sample exchange with other Clinical Laboratories

  • Interpretation:

    The liver isoenzyme is the most frequently elevated. A wide group of associated liver conditions can lead to increases in the liver isoenzyme, e.g. viral hepatitis, cirrhosis, drug induced liver di...

    The liver isoenzyme is the most frequently elevated. A wide group of associated liver conditions can lead to increases in the liver isoenzyme, e.g. viral hepatitis, cirrhosis, drug induced liver disease. It is also increased in malignancies with hepatic metastases, in cancer of the lungs and digestive tract and in lymphoma.

    Biliary isoenzyme (L2) (also called fast liver or macrohepatic) is associated with fragments of cell membranes derived from cells lining the biliary tract or from aggregation in bile or plasma of liver ALP with lipid or protein, e.g. PBC. Increases may occur in cholestasis and biliary diseases (e.g., cirrhosis, viral hepatitis) and in malignancies with liver metastases.

    Bone isoenzyme is elevated as a consequence of increased osteoblastic activity. Increased values are present in growing children and in adults over 50 years. Increased levels are found in Paget's, rickets, osteomalacia and bone cancer. Renal disorders can also result in increased bone isoenzyme levels.

    Intestinal isoenzyme(s) is increased in a variety of diseases of the digestive tract. This isoenzyme may also be increased with diabetes, chronic renal failure and cirrhosis of the liver, particularly in subjects with blood group 0.

    Placental isoenzyme(s) is found in serum of pregnant women, late in first trimester of pregnancy. It may also occur in a small proportion of patients with cancer.

    Immunoglobulin complex or macro-alkaline phosphatase is a fraction that is rarely found. It remains very close to the application point on both tracks.

    Lipoprotein-alkaline phosphatase complex also remains very close to the application point on both tracks. It may be found in biliary obstructive diseases.

    Isoenzymes with atypical migrations, such as Nago, Regan and Kasahara, are difficult to identify.

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  • Reference Ranges:

    Non-numeric result. Interpretative comment provided on report.

    Non-numeric result. Interpretative comment provided on report.

  • Routine Contact Name:

    Duty Biochemist

  • Routine Telephone:

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

    Freeman: 0191 244 8889
    RVI: 0191 282 9719

  • Routine Email:

    - For external users: TNU-Tr.duty.biochemist@nhs.net

    - For Trust users: DutyBiochemist@nuth.nhs.uk

Availability:

Available during full access hours
Assayed weekly
Site of analysis: RVI

Turn Around:

Within 3 weeks

Send To:

Department of Blood Sciences

Level 3
Leazes Wing
Royal Victoria Infirmary
Queen Victoria Road
Newcastle upon Tyne
NE1 4LP

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