The value of combined determination of high molecular mass API and LP-X in the differential diagnosis of intrahepatic and extrahepatic obstruction

Clinical chemistry

“…Alkaline phosphatase (AP) shares some common features with GT: both enzymes are sensitive indicators of cholestasis (218,219); they show a considerable heterogeneity in normal serum and particularly in patients' sera; and they demonstrate a tendency to react with serum constituents and to form macromolecular complexes. Serum AP may be released by liver, bone, placenta, or intestine.…”

“…Particularly in cholestasis several electrophoretic AP bands have been observed and a number of names proposed (218). Besides isoenzymes originating from liver, bone, placenta, and intestine, macromolecular forms are of specific interest: in cholestasis a liver AP-lipoprotein-X complex is seen (219), in hepatic malignancy a membraneparticle-AP is present, and, without special relation to any disorders, a Ig-linked AP has been identified (218,298). Ectopic or inappropriate expression of AP in tumors now is a well-recognized phenomenon.…”

Elevated Liver Isoenzymes of Alkaline Phosphatase and Disease Activity in Patients with Crohn’s Disease

“…The F-ALP is a high-molecular-weight and highly neg atively charged fraction of ALP in serum and is also called high-molecular-weight ALP [11,12], The origin of the fast liver isoenzyme is not yet completely clear, but these enzyme complexes also occur in bile and may be regurgi tated into blood in biliary obstruction [13,14], The pres ence of the fast liver fraction in serum is therefore regarded as a sign of cholestatic disease [12,15] or liver metastasis [16] which could be excluded in our patients. Fast liver isoenzyme correlated to parameters of hepato biliary disease such as GGT, total ALP, L-ALP, ALAT and ASAT, but also with parameters of disease activity as CDAI, OM, ESR and platelets.…”