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Forum Name: Pediatric Topics

Question: Alkaline Phosphate Levels


 kobejack - Tue Jun 12, 2007 4:19 pm

My 12 1/2 year old son since December has had 5 stomach bugs, bacterial pneumonia and 2 cases of the flu. His doctor did a full met, lytes and CBCD (I think I got the names right) blood test. His Creatine was a little low at 0.5 ml, his chloride was a little low at 100 ml and his alk phosphate was high at 520. A week after the first blood test we decided to do another alk phos. test. This one came back at 518 so we did a bone scan which came back normal. We did another alk. phos. test a week after the bone scan and its now up to 534. He thinks that my son might be going through a growth spurt. My son is not a sports player, but he is on a swim team. Our doctor wants to wait another 2 weeks to do the test again. Should we be checking his liver for disease or proper function? Or am I just getting nervous for nothing. Any suggestions?


Sincerely,

A Concerned Mom
p.s he also had his appendix out when he was 10.
 Dr. Chan Lowe - Tue Jun 12, 2007 9:36 pm

User avatar Really, his creatinine and chloride levels are normal for his age. I would not be worried at all about those.

I would recommend testing a GGT level with his next alkaline phosphatase test. If the GGT is elevated, the alk. phos. is coming from his biliary tract and he should be evaluated for gallstones, etc.

There is another entity called benign transient hyperphosphatasemia. This is when the alkaline phosphatase becomes elevated for an uncertain reason and remains elevated for 8-12 weeks then returns to normal. The alk. phos. levels can become quite elevated (in the thousands). No real problems are noted other than the elevated lab value. It is often preceded by a viral illness but the cause is not known.

This condition is more common in infants and toddlers but can be seen into adulthood. It is sometimes called "Ulysees Syndrome" because it leads doctors on a long journey to find the answer during which time the alk. phos. often returns to normal.

If his liver enzymes are normal except for the alk. phos. and he is otherwise well you may want to consider not checking it again for a month or so.

Best wishes. Keep us updated on what you find out.

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