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Related Experiment Video

Updated: Feb 15, 2026

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Elevated serum alkaline phosphatase · generalized pruritus · Dx?

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This case study highlights a pregnant woman with elevated alkaline phosphatase (ALP) and pruritus. Further investigation is crucial for diagnosing and managing liver conditions during pregnancy.

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Area of Science:

  • Hepatology
  • Obstetrics
  • Internal Medicine

Background:

  • A 34-year-old pregnant woman presented with generalized pruritus and elevated serum alkaline phosphatase (ALP).
  • Her obstetric history included two live births and two spontaneous abortions.
  • She had no significant past medical history or family history of liver disease.

Observation:

  • Physical examination revealed acanthosis nigricans and scattered excoriations.
  • Serum ALP levels were significantly elevated (1093 U/L, normal: 50-136 U/L), peaking at 1134 U/L by 37 weeks' gestation.
  • Liver function tests, including transaminases, albumin, bilirubin, and prothrombin time, were within normal limits.

Findings:

  • Fasting serum bile acid concentration was normal (9 mcmol/L, normal: 4.5-19.2 mcmol/L).
  • The patient's ALP levels were normal prior to pregnancy.
  • The elevated ALP and pruritus in the third trimester of pregnancy suggest a potential pregnancy-related liver condition.

Implications:

  • This case underscores the importance of monitoring liver function during pregnancy, especially in the presence of symptoms like pruritus.
  • Further diagnostic workup is necessary to determine the etiology of the elevated ALP and pruritus.
  • Timely diagnosis and management are essential for maternal and fetal well-being.