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Benign transient hyperphosphatasemia of infancy and childhood
1Department of Pediatrics, Robert C. Byrd Health Science Center of West Virginia University, Charleston, USA.
Insights
Benign transient hyperphosphatasemia (BTH) is a temporary condition causing high alkaline phosphatase (ALP) in children. Recognizing BTH avoids unnecessary medical evaluations for this harmless condition.
Area of Science:
- Pediatric Endocrinology
- Clinical Biochemistry
Background:
- Elevated serum alkaline phosphatase (ALP) in children can be a diagnostic challenge.
- Benign transient hyperphosphatasemia (BTH) is a poorly understood condition characterized by transiently high ALP levels.
Observation:
- Six children aged 11-25 months presented with markedly elevated serum ALP (1,077–9,271 U/L).
- These children had no underlying disease explaining the elevated ALP levels.
Findings:
- Diagnosis of BTH was confirmed when serum ALP levels normalized or significantly decreased within 3 months.
- The exact pathophysiology of BTH remains unclear despite several proposed theories.
Implications:
- Early recognition of BTH is crucial for clinicians.
- Avoiding extensive and unnecessary investigations in cases of suspected BTH can prevent patient and healthcare system burden.
Abstract:
Six children, aged 11 to 25 months, were found to have elevated serum alkaline phosphatase (ALP) levels (1,077 to 9,271 U/L) in the absence of disease. Benign transient hyperphosphatasemia (BTH) was diagnosed when the serum ALP levels returned to normal or decreased significantly within 3 months. Several theories have been suggested regarding the pathophysiology of BTH, but the exact cause is still unclear. We report six cases of BTH and review the literature. It is important to recognize this condition and to avoid extensive and unnecessary evaluation.