Clinical Utilization of Alkaline Phosphatase Measurements

McComb, Robert B.; Bowers, George N.; Posen, Solomon

doi:10.1007/978-1-4613-2970-1_9

Cited by 15 publications

(13 citation statements)

References 1,386 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For similar reasons, adynamic renal osteodystrophy may be associated with a relatively low, but rarely an absolutely low, serum ALP . Starvation and severe uncorrected nutrient or micronutrient deficiencies (protein, zinc, vitamins B 12 , and C) and electrolyte abnormalities have been associated with transiently low serum ALP levels . Untreated profound hypothyroidism, Celiac disease, Cushing's disease, and obstructive uropathy have rarely been associated with transiently low serum ALP, but more often the value is normal or even elevated, although comprehensive studies have not been reported .…”

Section: Discussionmentioning

confidence: 99%

“…Elevated serum ALP values are frequently encountered in clinical practice and usually indicate hepatobiliary or skeletal disease. (3) Conversely, a low serum ALP value (hypophosphatasemia) is uncommon in clinical practice and, in the absence of analytic error, the reported causes are wide ranging, sometimes anecdotal and often unfamiliar (3)(4)(5)(6)(7) (Table 1). Therefore, the etiology and clinical significance of hypophosphatasemia might be easily overlooked.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and Radiographic Findings in Adults With Persistent Hypophosphatasemia

McKiernan

Berg

Fuehrer

2014

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

A serum alkaline phosphatase value below the age-adjusted lower limits of normal (hypophosphatasemia) is uncommonly encountered in clinical practice. The electronic and paper medical records of 885,165 patients treated between 2002 and 2012 at a large, rural, multispecialty health clinic were interrogated to estimate the prevalence and characterize the clinical and radiographic findings of adults whose serum alkaline phosphatase was almost always low (persistent hypophosphatasemia). We hypothesized that some of these patients might harbor previously unrecognized hypophosphatasia, a rare, inherited condition of impaired mineralization of bones and teeth. Persistent hypophosphatasemia (serum alkaline phosphatase 30 IU/L) was found in 1 of 1544 adult patients. These adult patients had more crystalline arthritis, orthopedic surgery, chondrocalcinosis, calcific periarthritis, enthesopathy, and diffuse idiopathic skeletal hyperostosis than a general adult patient population. A gender effect was observed. The clinical and radiographic findings of adult patients with persistent hypophosphatasemia resemble those of the adult form of hypophosphatasia. Clinicians should take notice of persistent hypophosphatasemia, consider the diagnosis of hypophosphatasia, and be cautious when considering potent anti-remodeling therapy in these adults. This population warrants further evaluation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical and Radiographic Findings in Adults With Persistent Hypophosphatasemia

McKiernan

Berg

Fuehrer

2014

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

“…We excluded patients for whom the ALP assessment was performed in the emergency department, as stress can be associated with low ALP [9]. Between the 1st of January and the 31st of December 2013, 48,755 patients had at least one ALP assessment.…”

Section: Study Populationmentioning

confidence: 99%

Absence of recognition of low alkaline phosphatase level in a tertiary care hospital

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In infants -including those of the present investigationthere is a gradual increase of its activity during the first months of life [21,26], although plasma zinc decreases. In the present study formula-fed infants at 4 months of age, who had significantly lower plasma zinc levels, showed a significant correlation between alkaline phosphatase activity and length increment, whereas in the other infants with higher plasma zinc levels due to the intake of breastmilk or supplemented hypo-allergenic formula, there was only a trend a correlation.…”

Section: Zincmentioning

confidence: 87%

Zinc and copper in infants fed breast-milk or different formula

Lombeck

Fuchs

1994

Eur J Pediatr

View full text Add to dashboard Cite

In 129 term infants at birth and at the age of 4 months, zinc and copper concentrations of plasma and urine were determined by graphite furnace atomic absorption spectrophotometry and the values correlated to other biochemical parameters and somatic data. Of the infants, 49 were exclusively breast-fed, 44 fed with various commercially available cow's milk formula, 35 fed with a hypoallergenic formula (cows's milk whey hydrolysate, commercially available, supplemented with zinc and copper). Plasma zinc values declined from birth to the age of 4 months in all three groups (P < 0.001). In formula fed children, 4 months old, the values (11.1 +/- 1.7 mumol Zn/l) were significantly lower than in breast-fed (12.2 +/- 1.7 mumol Zn/l; P = 0.004) or babies on hypo-allergenic formula (12.4 +/- 1.6 mumol Zn/l; P = 0.0015). In accordance with the literature plasma copper and caeruloplasmin values increased significantly within the first 4 months of life, the plasma levels were similar in either feeding group, only urinary copper excretion was higher in male infants on hypo-allergenic formula (P < 0.03) at the age of 4 months. There were no correlations between zinc or copper values and alkaline phosphatase. In infants on hypo-allergenic formula there was a negative correlation between plasma zinc and weight or height increments. Despite different zinc and copper supply, presumedly different bioavailability, and different plasma zinc values, all infants thrived and weight and length increments were similar in each group.

show abstract

Clinical Utilization of Alkaline Phosphatase Measurements

Cited by 15 publications

References 1,386 publications

Clinical and Radiographic Findings in Adults With Persistent Hypophosphatasemia

Clinical and Radiographic Findings in Adults With Persistent Hypophosphatasemia

Absence of recognition of low alkaline phosphatase level in a tertiary care hospital

Zinc and copper in infants fed breast-milk or different formula

Contact Info

Product

Resources

About