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Plasma alkaline phosphatase activity: a screening test for rickets in preterm neonates
Lancet (London, England)
|February 6, 1982
Summary
Plasma alkaline phosphatase activity is common in preterm infants. Higher levels may indicate rickets, suggesting an acceptable threshold five times the adult normal range.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Endocrinology
Background:
- Rickets and elevated plasma alkaline phosphatase (ALP) are prevalent in preterm infants.
- Current reference data for ALP in preterm infants are lacking, hindering diagnosis.
- Accurate assessment is crucial for managing bone health in this vulnerable population.
Purpose of the Study:
- To establish reference data for plasma alkaline phosphatase activity in preterm infants.
- To correlate plasma ALP levels with the diagnosis of rickets.
- To identify potential diagnostic thresholds for rickets in preterm neonates.
Main Methods:
- Serial measurements of plasma alkaline phosphatase activity, calcium, and inorganic phosphorus were performed.
- Alkaline phosphatase isoenzyme patterns were analyzed in 30 preterm infants.
- Infants' clinical data and diagnosis of rickets were recorded.
Main Results:
- Four distinct patterns of plasma ALP activity changes over time were observed.
- All infants exhibited ALP levels above adult/childhood ranges at some point.
- Rickets were diagnosed in 4 infants; rachitic infants had significantly higher ALP levels.
Conclusions:
- Plasma ALP activity exceeding five times the adult upper limit may indicate rickets in preterm infants.
- Established reference data are needed for accurate ALP interpretation in this population.
- This study provides preliminary data to aid in the screening and diagnosis of rickets in preterm neonates.
