Bile canalicular alkaline phosphatase and disease

The alkaline phosphatase reaction is normally absent in human bile canaliculi, but was found in 79 patients. In search for a common causal factor, these patients were further examined. Thirty-seven were autopsied. The conditions most ocmmonly associated with the phenomenon were malignant tumours with or without involvement of the liver, collagen diseases, long-standing partial obstruction of the common bile duct, and genetic variants of alpha-1-antitrypsin. No clinical or laboratory facts were common to all the patients.