RAISED ALKALINE PHOSPHATASE

physiological:

bone:

preterm infants [up to 5X upper adult level]

children until puberty [up to 2-3X]

during puberty [up to 5-6X]

placenta:

pregnancy, esp. 3rd trimester

bone:

osteomalacia / rickets (hypovitaminosis D)

Paget's disease of bone [ALP may be very high; all other biochemistry normal]

metastatic bone disease

extensive osteogenic sarcoma

extensive 1° hyperparathyroidism [only slightly raised ALP]

liver:

cholestasis

space-occupying lesions, eg. tumour, granuloma, abscess, metastases

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