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Intestinal type alkaline phosphatase hyperphosphatasemia associated with liver cirrhosis
1Central Laboratory, School of Medicine, University of Ehime, Japan.
Clinica Chimica Acta; International Journal of Clinical Chemistry
|September 15, 1992
Summary
Elevated serum alkaline phosphatase, primarily of the intestinal type, was observed in a patient with liver cirrhosis. Further analysis revealed intestine-like alkaline phosphatase isoforms in the serum, differing from standard intestinal enzymes.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Enzymology
Background:
- Hyperphosphatasemia, characterized by elevated serum alkaline phosphatase (ALP), can arise from various conditions.
- Liver cirrhosis is a known factor that can influence serum ALP levels.
- The specific isoenzyme contributing to hyperphosphatasemia requires detailed characterization.
Purpose of the Study:
- To investigate the source and characteristics of elevated serum alkaline phosphatase in a patient with asymptomatic liver cirrhosis.
- To determine the proportion and nature of the intestinal-type alkaline phosphatase in the patient's serum.
- To compare the biochemical properties of serum alkaline phosphatase with standard intestinal ALP.
Main Methods:
- Measurement of total serum alkaline phosphatase activity.
- Immunoprecipitation to quantify the intestinal isoenzyme.
- Electrophoresis and isoelectrofocusing for isoenzyme separation and characterization.
- Lectin affinity chromatography to analyze sugar chain composition.
- Enzymological studies including heat lability and neuraminidase resistance.
Main Results:
- The patient presented with significantly elevated serum alkaline phosphatase (828 U/l), with 94% identified as intestinal type.
- Electrophoresis and isoelectrofocusing revealed multiple intestine-like alkaline phosphatase components in the serum.
- These serum components exhibited heat lability and neuraminidase resistance.
- Lectin affinity chromatography demonstrated distinct sugar chain compositions compared to standard intestinal ALP.
- Enzymological studies indicated the presence of several intestine-like alkaline phosphatase isoforms.
Conclusions:
- The patient's hyperphosphatasemia was predominantly due to intestinal-type alkaline phosphatase.
- The serum alkaline phosphatase consisted of multiple isoforms with characteristics similar to, but not identical to, standard intestinal enzyme.
- These findings suggest the presence of unique, intestine-like alkaline phosphatase isoforms in the serum of this patient with liver cirrhosis.