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Alkaline Phosphatase > 2000 U/L in an Infant With Stool Changes: A Case Report
1Department of Family Medicine, Loma Linda University, Loma Linda, CA, USA.
The Permanente Journal
|July 9, 2024
Summary
Transient hyperphosphatasemia (TH) is a benign, self-limiting condition in young children. This case highlights how elevated alkaline phosphatase (ALP) levels can resolve with monitoring, avoiding unnecessary tests.
Area of Science:
- Pediatrics
- Clinical Biochemistry
Background:
- Transient hyperphosphatasemia (TH) is a benign condition characterized by elevated serum alkaline phosphatase (ALP) in healthy children.
- It typically affects those under 5 years old and resolves spontaneously within months.
Observation:
- A 12-month-old girl presented with pale stools and incidentally elevated ALP (2379 IU/L).
- Physical examination revealed a small anal fissure; other findings were unremarkable.
- Differential diagnoses included serious conditions like biliary atresia and liver disease.
Findings:
- Extensive laboratory tests (CBC, CMP, calcium, phosphate, etc.) and liver ultrasound were normal.
- The diagnosis of TH was confirmed.
- ALP levels normalized within 2 months during clinical observation.
Implications:
- This case underscores the importance of recognizing TH to prevent unnecessary diagnostic workups in children.
- Awareness of TH can lead to cost savings and reduced patient anxiety.
- Management involves clinical observation and serial ALP measurements, confirming its benign, self-limiting nature.
