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Transient hyperphosphatasaemia of infancy

E Schönau1, K H Herzog, H J Böhles

  • 1Kinderklinik, Friedrich-Alexander Universität Erlangen-Nürnberg, Federal Republic of Germany.

Insights

High alkaline phosphatase activity in transient hyperphosphatasaemia (THP) may stem from atypical isoenzymes. This finding, particularly after rotavirus infection, could aid in diagnosing THP.

Area of Science:

  • Biochemistry
  • Clinical Chemistry
  • Pediatrics

Background:

  • Transient hyperphosphatasaemia (THP) is a benign condition characterized by elevated serum phosphate levels.
  • Alkaline phosphatase (ALP) is an enzyme with several isoenzymes, commonly measured in clinical diagnostics.

Observation:

  • Five patients with THP exhibited elevated levels of "atypical" alkaline phosphatase (ALP) or its fragment isoenzymes.
  • One case of THP with atypical ALP was observed following rotavirus infection.

Findings:

  • Incubation with neuraminidase suggested that atypical ALP originated from highly glycosylated bone and liver ALP isoenzymes.
  • Virus-induced reduction in isoenzyme clearance from serum is a potential mechanism for elevated atypical ALP in THP.
  • The study tracked the changes in isoenzyme activities during THP following rotavirus infection.

Implications:

  • The determination of atypical alkaline phosphatase may serve as a useful diagnostic marker for transient hyperphosphatasaemia.
  • Understanding the biochemical alterations in THP can improve diagnostic accuracy and patient management.

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