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A case of transient hyperphosphatasaemia of infancy associated with a probable allergic disorder
K Tanishima1, Q Ying, T Hashimoto
1Department of Clinical Laboratory Sciences, School of Allied Medical Professions, Kanazawa University, Japan.
Insights
Transient hyperphosphataemia in a child showed markedly elevated serum alkaline phosphatase (ALP). Bone and liver ALP isoenzymes were identified, with allergy possibly contributing to the condition.
Area of Science:
- Biochemistry
- Pediatrics
- Clinical enzymology
Background:
- Transient hyperphosphataemia is a rare condition characterized by temporary elevations in serum alkaline phosphatase (ALP).
- The etiology of transient hyperphosphataemia is often unclear, but various factors have been implicated.
Observation:
- A 2-year-old female child presented with grossly elevated serum ALP activity (8594 U/L).
- The child's ALP levels gradually normalized over the following two months.
Findings:
- Electrophoresis revealed two distinct ALP activity bands: a cathodic band of bone origin and an anodic band identified as sialylated liver ALP.
- Isoenzyme analysis confirmed the bone and liver origins of the elevated ALP fractions.
Implications:
- This case highlights the importance of isoenzyme analysis in diagnosing the source of elevated ALP in pediatric patients.
- The findings suggest a potential contributory role of allergic disorders in transient hyperphosphataemia, warranting further investigation.
Abstract:
Serum alkaline phosphatase (ALP) activity was found to be grossly elevated (8594 U/L) in a 2-year-old female child, returning towards normal during the subsequent 2 months. Electrophoresis revealed two bands of ALP activity; isoenzyme analysis identified the cathodic band as being of bone origin and the anodic band as sialylated liver ALP. Whilst the aetiology of transient hyperphosphataemia remains unclear a probable allergic disorder appears to be a contributory factor in this patient.