Transient hyperphosphatasemia of infancy and childhood

A study of serum alkaline phosphatase by electrofocusing techniques

J. Griffiths, A. Vernocchi, E. Simoni

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21 Citations (Scopus)

Abstract

Objective. - To evaluate serum alkaline phosphatase (ALP) isoenzymes, using a sensitive electrofocusing technique, in transient hyperphosphatasemia of infancy and childhood. Design. - Randomized study of infants and children who provided serum samples when an unusual magnitude of total ALP activity was noted. Setting. - Reference enzyme laboratories in Gorizia and Bergamo (Italy) and in Charleston, SC (USA). Patients. - A total of 135 infants and children noted to have markedly increased total ALP activity. Main Outcome Measures. - Recognition of the disease pathogenesis with appropriate treatment instituted. Results. - Three groups of patients were identified: (1) previously healthy patients who showed additional laboratory evidence of viral and protozoal infection, in whom the ALP isoenzyme pattern reflected the primary target organ(s) of the infection; (2) patients with clinical evidence of failure to thrive due to preexisting disease, along with a superimposed infection (the ALP isoenzyme pattern reflected the specific infection and fractions associated with the primary disease); and (3) patients exhibiting failure to thrive (nonorganic or caloric deficit) who did not show evidence of infection. The total ALP in the third group was lower than in the other groups, was of hepatic and bone origin, and decreased when a positive caloric balance was established. Conclusion. - We examined several mechanisms to explain the hyperphosphatasemia. A perplexing question remains: Will a small group of infants and children respond to infection with this magnitude of ALP activity? Conversely, do all children respond, but a small number fortuitously undergo laboratory measurements that include ALP levels?

Original languageEnglish
Pages (from-to)784-789
Number of pages6
JournalArchives of Pathology and Laboratory Medicine
Volume119
Issue number9
Publication statusPublished - 1995

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Isoelectric Focusing
Alkaline Phosphatase
Serum
Isoenzymes
Infection
Failure to Thrive
Preexisting Condition Coverage
Virus Diseases
Italy
Outcome Assessment (Health Care)
Bone and Bones
Liver
Enzymes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

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title = "Transient hyperphosphatasemia of infancy and childhood: A study of serum alkaline phosphatase by electrofocusing techniques",
abstract = "Objective. - To evaluate serum alkaline phosphatase (ALP) isoenzymes, using a sensitive electrofocusing technique, in transient hyperphosphatasemia of infancy and childhood. Design. - Randomized study of infants and children who provided serum samples when an unusual magnitude of total ALP activity was noted. Setting. - Reference enzyme laboratories in Gorizia and Bergamo (Italy) and in Charleston, SC (USA). Patients. - A total of 135 infants and children noted to have markedly increased total ALP activity. Main Outcome Measures. - Recognition of the disease pathogenesis with appropriate treatment instituted. Results. - Three groups of patients were identified: (1) previously healthy patients who showed additional laboratory evidence of viral and protozoal infection, in whom the ALP isoenzyme pattern reflected the primary target organ(s) of the infection; (2) patients with clinical evidence of failure to thrive due to preexisting disease, along with a superimposed infection (the ALP isoenzyme pattern reflected the specific infection and fractions associated with the primary disease); and (3) patients exhibiting failure to thrive (nonorganic or caloric deficit) who did not show evidence of infection. The total ALP in the third group was lower than in the other groups, was of hepatic and bone origin, and decreased when a positive caloric balance was established. Conclusion. - We examined several mechanisms to explain the hyperphosphatasemia. A perplexing question remains: Will a small group of infants and children respond to infection with this magnitude of ALP activity? Conversely, do all children respond, but a small number fortuitously undergo laboratory measurements that include ALP levels?",
author = "J. Griffiths and A. Vernocchi and E. Simoni",
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AU - Simoni, E.

PY - 1995

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AB - Objective. - To evaluate serum alkaline phosphatase (ALP) isoenzymes, using a sensitive electrofocusing technique, in transient hyperphosphatasemia of infancy and childhood. Design. - Randomized study of infants and children who provided serum samples when an unusual magnitude of total ALP activity was noted. Setting. - Reference enzyme laboratories in Gorizia and Bergamo (Italy) and in Charleston, SC (USA). Patients. - A total of 135 infants and children noted to have markedly increased total ALP activity. Main Outcome Measures. - Recognition of the disease pathogenesis with appropriate treatment instituted. Results. - Three groups of patients were identified: (1) previously healthy patients who showed additional laboratory evidence of viral and protozoal infection, in whom the ALP isoenzyme pattern reflected the primary target organ(s) of the infection; (2) patients with clinical evidence of failure to thrive due to preexisting disease, along with a superimposed infection (the ALP isoenzyme pattern reflected the specific infection and fractions associated with the primary disease); and (3) patients exhibiting failure to thrive (nonorganic or caloric deficit) who did not show evidence of infection. The total ALP in the third group was lower than in the other groups, was of hepatic and bone origin, and decreased when a positive caloric balance was established. Conclusion. - We examined several mechanisms to explain the hyperphosphatasemia. A perplexing question remains: Will a small group of infants and children respond to infection with this magnitude of ALP activity? Conversely, do all children respond, but a small number fortuitously undergo laboratory measurements that include ALP levels?

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