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Benign transient hyperphosphatasemia
Insights
Benign transient hyperphosphatasemia (BTHP) is a temporary condition causing high alkaline phosphatase (AP) levels in children, often linked to infections. This self-resolving disorder requires no further investigation, preventing unnecessary medical tests.
Area of Science:
- Pediatric Endocrinology
- Clinical Biochemistry
Background:
- Benign transient hyperphosphatasemia (BTHP) is a rare, self-limiting condition characterized by markedly elevated serum alkaline phosphatase (AP) levels.
- It is typically observed in infants and young children, often incidentally discovered during mild infections or routine health check-ups.
Purpose of the Study:
- To describe the clinical features and diagnostic criteria of BTHP in a pediatric cohort.
- To emphasize the importance of recognizing BTHP to avoid unnecessary diagnostic workups for liver or bone disease.
Main Methods:
- Retrospective case series analysis of nine children diagnosed with BTHP over a two-year period.
- Review of clinical presentations, laboratory findings (specifically serum alkaline phosphatase levels), and follow-up data.
Main Results:
- Nine children diagnosed with BTHP, presenting with 3-50 fold elevation in serum AP levels.
- Elevated AP levels were associated with mild infections (respiratory or gastrointestinal) and normalized within 12 weeks.
- No evidence of underlying bone or liver pathology was found in any patient.
Conclusions:
- BTHP is a benign, transient condition that can be diagnosed based on characteristic laboratory findings and clinical presentation.
- Prompt recognition of BTHP can prevent extensive and unnecessary investigations for more serious conditions.
- Awareness among pediatricians is crucial for accurate diagnosis and appropriate patient management.
Abstract:
Benign transient hyperphosphatasemia (BTHP) was diagnosed in nine children who were examined in the Pediatric Department at Beilinson Medical Center during 2 years. The characteristic features of this disorder are: a) elevation of serum alkaline phosphatase (AP) of 3-50 fold the upper normal value for age, usually discovered during mild upper respiratory or gastrointestinal infection, and sometimes by routine laboratory workup; b) no clinical or laboratory evidence of bone or liver disease; c) the elevated AP is of liver and bone origin; and d) AP returns to normal range within 12 weeks. BTHP usually occurs in infants but may appear also in adults. Recognition of this benign entity will prevent extensive unnecessary laboratory workup.