physiologic reasons for high alkaline phosphatase

 Q; Patients may have elevated alkaline phosphatase (AP) depending on their blood type? 

A) True 

B) False 

Answer: A 

In the human body, there are two major sources of AP: liver and bones. Also, there are many physiologic reasons for elevated AP, for which no further intervention or investigation is required. Some of such conditions are:

1. Third trimester of pregnancy. This is due to the influx of the placental AP in maternal blood. 

2. Infants, toddlers, and adolescents due to increased osteoblastic activity. 

3. Women in the age group 40 and above. This correlates with higher age. 

4. Diabetes mellitus. 

5. Familial increased intestinal alkaline phosphatase. 

6. Interestingly people with blood types O and B may have elevated AP after eating a fatty meal.

#hepatology

References:

1. Siddique A, Kowdley KV. Approach to a patient with elevated serum alkaline phosphatase. Clin Liver Dis. 2012;16(2):199-229. doi:10.1016/j.cld.2012.03.01

2. Lowe D, Sanvictores T, John S. Alkaline Phosphatase. 2020 Aug 30. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 29083622.

3. Nannipieri M, Gonzales C, Baldi S, et al. Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care 2005; 28:1757.

4. Lieverse AG, van Essen GG, Beukeveld GJ, et al. Familial increased serum intestinal alkaline phosphatase: a new variant associated with Gilbert's syndrome. J Clin Pathol. 1990;43(2):125-128. doi:10.1136/jcp.43.2.125