If Hoofbeats are not From Horses, It Could be Zebras!! Isolated Hyper-alkaline Phosphatasemia

Mahak Chauhan; David H. Alpers; James P. Hamilton; Paul J. Thuluvath

doi:10.1016/j.jceh.2020.12.001

If Hoofbeats are not From Horses, It Could be Zebras!! Isolated Hyper-alkaline Phosphatasemia

Mahak Chauhan, David H. Alpers, James P. Hamilton, Paul J. Thuluvath

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Alkaline phosphatase (AP) is a membrane bound enzyme and when it is elevated in blood, it is mostly due to either hepatobiliary or bone diseases. We report isolated intestinal hyperphosphatasemia (IAP) in two sisters. Both sisters presented with identical trends of isolated AP elevation. Both underwent extensive workup for liver diseases including cholangiograms, and none was identified. Subsequent isoenzyme electrophoresis showed that 45%–56% of the elevated AP was due to IAP. This elevation of the intestinal AP is consistent with a rare hereditary biochemical abnormality, benign familial intestinal hyperphosphatemia. This condition should be considered in the differential diagnosis of otherwise isolated serum AP levels to avoid unnecessary investigations.

Original language	English (US)
Pages (from-to)	619-622
Number of pages	4
Journal	Journal of Clinical and Experimental Hepatology
Volume	11
Issue number	5
DOIs	https://doi.org/10.1016/j.jceh.2020.12.001
State	Published - Sep 1 2021

Keywords

alkaline phosphatase isozyme
elevated alkaline phosphatase
familial benign intestinal alkaline hyperphosphatasemia
hyperphosphatasemia

ASJC Scopus subject areas

Hepatology

Access to Document

10.1016/j.jceh.2020.12.001

Cite this

@article{5dd871cbfc9a46ab91448ad546114398,

title = "If Hoofbeats are not From Horses, It Could be Zebras!! Isolated Hyper-alkaline Phosphatasemia",

abstract = "Alkaline phosphatase (AP) is a membrane bound enzyme and when it is elevated in blood, it is mostly due to either hepatobiliary or bone diseases. We report isolated intestinal hyperphosphatasemia (IAP) in two sisters. Both sisters presented with identical trends of isolated AP elevation. Both underwent extensive workup for liver diseases including cholangiograms, and none was identified. Subsequent isoenzyme electrophoresis showed that 45%–56% of the elevated AP was due to IAP. This elevation of the intestinal AP is consistent with a rare hereditary biochemical abnormality, benign familial intestinal hyperphosphatemia. This condition should be considered in the differential diagnosis of otherwise isolated serum AP levels to avoid unnecessary investigations.",

keywords = "alkaline phosphatase isozyme, elevated alkaline phosphatase, familial benign intestinal alkaline hyperphosphatasemia, hyperphosphatasemia",

author = "Mahak Chauhan and Alpers, {David H.} and Hamilton, {James P.} and Thuluvath, {Paul J.}",

note = "Publisher Copyright: {\textcopyright} 2020 Indian National Association for Study of the Liver",

year = "2021",

month = sep,

day = "1",

doi = "10.1016/j.jceh.2020.12.001",

language = "English (US)",

volume = "11",

pages = "619--622",

journal = "Journal of Clinical and Experimental Hepatology",

issn = "0973-6883",

publisher = "Elsevier BV",

number = "5",

}

TY - JOUR

T1 - If Hoofbeats are not From Horses, It Could be Zebras!! Isolated Hyper-alkaline Phosphatasemia

AU - Chauhan, Mahak

AU - Alpers, David H.

AU - Hamilton, James P.

AU - Thuluvath, Paul J.

PY - 2021/9/1

Y1 - 2021/9/1

N2 - Alkaline phosphatase (AP) is a membrane bound enzyme and when it is elevated in blood, it is mostly due to either hepatobiliary or bone diseases. We report isolated intestinal hyperphosphatasemia (IAP) in two sisters. Both sisters presented with identical trends of isolated AP elevation. Both underwent extensive workup for liver diseases including cholangiograms, and none was identified. Subsequent isoenzyme electrophoresis showed that 45%–56% of the elevated AP was due to IAP. This elevation of the intestinal AP is consistent with a rare hereditary biochemical abnormality, benign familial intestinal hyperphosphatemia. This condition should be considered in the differential diagnosis of otherwise isolated serum AP levels to avoid unnecessary investigations.

AB - Alkaline phosphatase (AP) is a membrane bound enzyme and when it is elevated in blood, it is mostly due to either hepatobiliary or bone diseases. We report isolated intestinal hyperphosphatasemia (IAP) in two sisters. Both sisters presented with identical trends of isolated AP elevation. Both underwent extensive workup for liver diseases including cholangiograms, and none was identified. Subsequent isoenzyme electrophoresis showed that 45%–56% of the elevated AP was due to IAP. This elevation of the intestinal AP is consistent with a rare hereditary biochemical abnormality, benign familial intestinal hyperphosphatemia. This condition should be considered in the differential diagnosis of otherwise isolated serum AP levels to avoid unnecessary investigations.

KW - alkaline phosphatase isozyme

KW - elevated alkaline phosphatase

KW - familial benign intestinal alkaline hyperphosphatasemia

KW - hyperphosphatasemia

UR - http://www.scopus.com/inward/record.url?scp=85098853632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85098853632&partnerID=8YFLogxK

U2 - 10.1016/j.jceh.2020.12.001

DO - 10.1016/j.jceh.2020.12.001

M3 - Article

C2 - 34511824

AN - SCOPUS:85098853632

SN - 0973-6883

VL - 11

SP - 619

EP - 622

JO - Journal of Clinical and Experimental Hepatology

JF - Journal of Clinical and Experimental Hepatology

IS - 5

ER -

If Hoofbeats are not From Horses, It Could be Zebras!! Isolated Hyper-alkaline Phosphatasemia

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this