Clinical significance of an increased or decreased serum alkaline phosphatase level

An increase in the level of serum alkaline phosphatase (ALP) may be caused by a wide variety of pathologic lesions that involve multiple organs, since the enzyme is an ubiquitous one. Before one attempts to identify a significant pathologic abnormality, the clinician should consider the possibility of a physiologic or spurious cause for an increased level of ALP. A decreased ALP level also has diagnostic value.