Benign transient hyperphosphatasemia in infants and children: a retrospective database study

Area of Science:

• Pediatrics
• Clinical Chemistry
• Biochemistry

Background:

• Benign transient hyperphosphatasemia is characterized by elevated serum alkaline phosphatase (ALP) without evidence of bone or liver disease.
• This condition is often discovered incidentally during routine blood tests in otherwise healthy children.
• It typically resolves spontaneously without intervention.

Purpose of the Study:

• To describe the demographic and clinical characteristics of benign transient hyperphosphatasemia in a cohort of healthy infants and children.
• To enhance recognition of this benign condition to avoid unnecessary investigations and parental anxiety.

Main Methods:

• Retrospective review of electronic medical records for children aged 1 day to 18 years diagnosed with benign transient hyperphosphatasemia.
• Data collected from 3 central districts in Israel between January 1, 2000, and December 31, 2020.
• Analysis of demographic and clinical characteristics, including serum ALP levels.

Main Results:

• The study included 382 infants and children aged 2 months to 14 years with serum ALP > 1000 U/L (mean 2557 U/L).
• The majority (87%) were under 24 months old (median age 14 months).
• A history of recent infections (fever, gastroenteritis, diarrhea, otitis media, viral infections) was common; a seasonal peak was noted in autumn-early winter.

Conclusions:

• Benign transient hyperphosphatasemia is a benign disorder in healthy infants and children that resolves spontaneously.
• Exclusion of other causes of elevated serum ALP, particularly bone and liver disease, is crucial.
• Increased awareness and recognition are vital to prevent unnecessary diagnostic tests and alleviate parental concerns.