Transient hyperphosphatasemia--where do we stand?

Area of Science:

• Pediatrics
• Biochemistry
• Endocrinology

Background:

• Transient hyperphosphatasemia of infancy and early childhood (THI) involves temporary elevations in serum alkaline phosphatase (S-ALP) in children under five.
• This condition presents without clinical or biochemical evidence of metabolic bone disease or liver dysfunction.
• Over 400 cases have been reported, suggesting a notable, albeit transient, pediatric health phenomenon.

Purpose of the Study:

• To summarize the characteristics, proposed etiologies, and clinical outcomes of THI.
• To emphasize the benign nature of THI and guide against unnecessary diagnostic interventions.

Main Methods:

• Review of existing literature and case reports on THI.
• Analysis of clinical presentations, biochemical findings, and follow-up data of affected children.

Main Results:

• THI is characterized by elevated S-ALP, primarily bone or liver isoforms, in children under five.
• No common underlying disease is identified, though viral etiology and multifactorial pathogenesis are suggested.
• Prospective follow-up confirms THI is benign, with normal growth and bone density.

Conclusions:

• THI is a transient, benign condition in young children.
• The pathogenesis is likely multifactorial, possibly involving viral triggers.
• Children diagnosed with THI should not undergo extensive diagnostic workups due to the condition's favorable prognosis.