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Transient hyperphosphatasemia in children revisited.

Neta Dori¹, Lily Levi, Tamar Stam

¹Department of Pediatrics Pediatric Surgery, Bnai Zion Medical Center, Maccabi Health Services, Haifa, Israel.

Pediatrics International : Official Journal of the Japan Pediatric Society

|October 30, 2010

Summary

Transient hyperphosphatasemia (TH) in children often presents with elevated bone alkaline phosphatase (ALP) and is frequently diagnosed in the latter half of the year. The exact cause remains unclear, suggesting a complex mechanism involving various stimuli.

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Area of Science:

Pediatric Endocrinology
Clinical Biochemistry
Medical Diagnostics

Background:

Transient hyperphosphatasemia (TH) is a recognized condition, yet its origins and underlying mechanisms are not fully understood.
Existing knowledge on TH lacks detailed clinical characterization, particularly in pediatric populations.

Purpose of the Study:

To investigate the clinical features of children diagnosed with TH.
To compare current findings with previous studies to enhance understanding of TH.
To identify potential subgroups of children at higher risk for developing TH.

Main Methods:

Retrospective analysis of 60 children diagnosed with TH between 2003-2008.
Inclusion of 122 age, gender, and symptom-matched controls.
Categorization of patients into subgroups based on presenting symptoms (infectious disease, failure to thrive, diarrhea, other).
Utilized Hydragel ISO-PAL kits for ALP isoenzyme analysis.

Main Results:

Elevated alkaline phosphatase (ALP) levels (mean 2311 U/L) were observed in TH patients, with no significant differences across symptom subgroups.
The average duration of TH was 12 weeks.
Bone isoenzyme of ALP was elevated in most analyzed cases.
A majority of diagnoses (71%) occurred in the second half of the calendar year.

Conclusions:

No definitive etiological explanation for TH was established in this study.
TH is presumed to result from a complex interplay of factors leading to enzyme upregulation.
Further research is needed to elucidate the precise pathophysiology of TH.