Transient Benign Hyperphophatasemia

Gualco, Gianluca; Lava, Sebastiano A. G.; Garzoni, Luca; Simonetti, Giacomo D.; Bettinelli, Alberto; Milani, Gregorio P.; Provero, Maria Cristina; Bianchetti, Mario G.

doi:10.1097/mpg.0b013e3182922807

Cited by 36 publications

(89 citation statements)

References 39 publications

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“…1,2 Despite the criteria shown in Table 1, there are studies 8 describing patients older than age 5 years, and approximately 25% of published cases occurred in children age 37 months or older or in adults. The normalization period of the elevated serum ALP was more than 17 weeks in approximately 20% of the published cases.…”

Section: 5mentioning

confidence: 99%

“…The normalization period of the elevated serum ALP was more than 17 weeks in approximately 20% of the published cases. 4,8 Most children with BTH are healthy, and the condition often occurred in clinical situations such as gastroenteritis, respiratory infections, other viral infections with EBV, enteroviruses, HIV, failure to thrive, and asthma. 2,4,[8][9][10] Approximately 13% of published pediatric cases of BTH occurred in patients with a pre-existing chronic disease such as leukemia, lymphoma, liver disease, rickets, and other metabolic osseous activity, and also in children who had undergone kidney or liver transplant.…”

Section: 5mentioning

confidence: 99%

“…4,8 Most children with BTH are healthy, and the condition often occurred in clinical situations such as gastroenteritis, respiratory infections, other viral infections with EBV, enteroviruses, HIV, failure to thrive, and asthma. 2,4,[8][9][10] Approximately 13% of published pediatric cases of BTH occurred in patients with a pre-existing chronic disease such as leukemia, lymphoma, liver disease, rickets, and other metabolic osseous activity, and also in children who had undergone kidney or liver transplant. 8,11 In such situations, the values of serum ALP are less elevated than those found in BTH, and may reflect frequent laboratory testing to monitor the preexisting disease.…”

Section: 5mentioning

confidence: 99%

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An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Shapira¹,

Shaoul²

2015

Pediatr Ann

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A n 18-month-old boy presented to his primary care pediatrician with a complaint of diarrhea for the past 5 days. The diarrhea was frequent, watery, but without mucus or blood. The diarrhea was not associated with vomiting, fever, cough, or skin rash. His past medical history is significant only for mild asthma, and his immunizations are up-to-date.The physical examination revealed an alert, well-developed boy with a weight of 11.9 kg (54th percentile), height of 84.5 cm (77th percentile), and normal vital signs. His abdomen was soft, nontender, and without hepatosplenomegaly or signs of dehydration. The rest of the physical examination was normal.A clinical diagnosis of viral gastroenteritis was made and oral rehydration therapy and dietary modifications were recommended. After 3 days he returned to the clinic because of the persistence of the diarrhea, and there were still no other symptoms. Once again, the results of his physical examination were normal. Because of the continuation of the diarrhea, laboratory tests (blood, urine, and stool) were performed, and the results were as follows: hemoglobin, 11.5 g/dL; white blood cells, 9.2 10 3 /mcL; platelets, 367 10 3 /mcL (with a normal differential count); C-reactive protein, <0.5 mg/dL; glucose, 75 mg/dL; urea, 25 mg/dL; creatinine, 0.20 mg/dL; potassium, 4.3 nmol/L; sodium, 138 nmol/L; protein, 6.2 g/dL; albumin, 4.1 g/dL; bilirubin, 0.20 mg/dL; ferritin, 20 ng/mL; asparate aminotransferase, 37 U/L; alanine aminotransferase, 26 U/L; gamma-glutamyl transpeptidase, 5 U/L; calcium, 9.3 mg/dL; and phosphorus, 4.9 mg/dL. Urinalysis was normal, and stool for culture, ova, parasites, Giardia lamblia antigen, rotavirus, and adenovirus was negative. Blood serology was negative for Epstein-Barr virus (EBV), hepatitis C, and for immunoglobulin M cytomegalovirus (CMV) antibodies, and positive for immunoglobulin G CMV antibodies, indicating a past infection with CMV.An elevated biochemical parameter in the blood revealed a condition that may be associated with the clinical presentation (gastroenteritis) described, appearing mainly in infancy and early childhood.

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Section: 5mentioning

confidence: 99%

Section: 5mentioning

confidence: 99%

Section: 5mentioning

confidence: 99%

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An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Shapira¹,

Shaoul²

2015

Pediatr Ann

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“…This resulted in hypercarotenemia, the real cause of his "jaundice" (5). The final diagnoses were transient hyperphosphatasemia of infancy (THI) and hypercarotenemia (3)(4)(5). The boy's diet was adjusted to current recommendations and he also returned to the regular daily dosage of 500 IU of cholecalciferol.…”

mentioning

confidence: 99%

“…A detailed personal history revealed that child was exclusively receiving carrots in vegetable soup. This resulted in hypercarotenemia, the real cause of his "jaundice" (5). The final diagnoses were transient hyperphosphatasemia of infancy (THI) and hypercarotenemia (3)(4)(5).…”

mentioning

confidence: 99%

Erroneous diagnosis of rickets

Kutı́lek

Skálová

2017

Turk Pediatri Ars

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Transient hyperphosphatasemia: Possible association with pediatric acute respiratory infection

Sakurai

Higashiguchi

2021

Pediatric Investigation

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ImportanceAcute respiratory infections are quite prevalent in children. Transient hyperphosphatasemia (TH) is defined as the transient elevation of serum alkaline phosphatase (ALP) level, which occurs mainly in infants and children without liver or bone disorders. Although no apparent cause has been identified, a possible association of respiratory infections with TH has been reported in the literature.ObjectiveIn this study, we aimed to investigate the association between TH and respiratory infectious diseases.MethodsWe collected the results of biochemical investigations, including ALP level, for a period of 5 years in our hospital. We then examined the patients with transiently elevated ALP levels of > 2000 U/L.ResultsDuring the observation period, 1501 blood samples were collected from 1097 patients. Marked elevation of serum ALP level was observed in 12 patients. All patients with hyperphosphatasemia, except for one with Fanconi syndrome attributable to the underlying Wilson’s disease, were aged < 5 years and were diagnosed with TH. Ten of these 11 patients with TH had acute respiratory infections. Marked ALP elevation was not found in any patients with non‐inflammatory diseases. ALP isoenzyme profiles showed a characteristic pattern in all six patients in whom the ALP isoenzyme test was conducted.InterpretationOur results suggest an association between respiratory infections and TH. The consideration of TH in patients with acute respiratory infections may lead to earlier and accurate diagnosis of this condition, thereby avoiding unnecessary medical interventions.

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Transient Benign Hyperphophatasemia

Cited by 36 publications

References 39 publications

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Erroneous diagnosis of rickets

Transient hyperphosphatasemia: Possible association with pediatric acute respiratory infection

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