Serum alkaline phosphatase activity

Dose and end point used for MRL derivation 0.18 mg/kg/day for increase in serum alkaline phosphatase activity. 

Roos, R. A simplified method for the determination of serum alkaline phosphatase activity. Scand. J. Clin. 

Alprostadil infusion can produce bone cortical hyperostosis. Periosteal changes have been described in 15 neonates after the administration of alprostadil for more than 1 week (10). Serum alkaline phosphatase activity was significantly raised. The long bones and clavicles were most commonly involved and symmetrically affected. The scapula was involved in two cases and the ribs in seven. The involvement of clavicles has not been previously reported. 

Shaver, WA., Bhatt, H., Combes, B. Low serum alkaline phosphatase activity in Wilson s disease. Hepatology 1986 6 859—863... 

Balasubramaniam, K., Wiesner, R.H., LaRusso, N.F. Primary sclerosing cholangitis with normal serum alkaline phosphatase activity. Gastroenterology 1988 95 1395-1398... 

The possibilities that cryptic prostatic carcinoma may coexist with other diseases or that a high serum alkaline phosphatase activity possesses some residual activity at pH 5.0 tend to be negated by an analysis of these five patients. One female with carcinoma of the breast and osteolytic metastases of the femur, pelvis, and spine had an elevated serum acid phosphatase activity of 4.2 K.A. units, and a second female with an unknown primary but with osteolytic lesions of the ribs and scapula had an activity of 4.1 K.A. units. The serum alkaline phosphatase activities were 17.8 Bodansky units in the first case and 5.2 Bodansky units in the second case, both above 4.2 Bodansky units, the upper limit of normal values by this method. 

One female and one male patient had hyperparathyroidism with elevated serum alkaline phosphatase activities and extensive bone changes characteristic of generalized osteitis fibrosa cystica. In both instances, the serum acid phosphatase activity of the serum fell to normal values after removal of the parathyroid adenoma despite transitorily increased serum alkaline phosphatase activity. The fifth patient was a female with osteopetrosis involving the major part of the skeleton. The serum acid phosphatase was 8.7 K.A. units, the highest in the control series— yet the serum alkaline phosphatase was within normal limits. It would appear, therefore, that some patients with skeletal disease may have a slight but definitely elevated serum acid phosphatase activity, at least as determined by the Gutman method (GIO, G14), which cannot be explained by concurrent prostatic carcinoma or by a spillover of alkaline phosphatase activity to a pH of 5.0. 

Using the Bodansky (B18, 52) procedure with 8-glycerophosphate as substrate, Woodard (W8) was unable to obtain such elevations. She determined the serum acid phosphatase activities in 83 females and 342 males, or a total of 425 patients with miscellaneous diseases. Of these, 61 had various types of infectious or metabolic disorders, including 11 cases of inflammatory disease of bone and 12 cases of hepatic cirrhosis. The remainder had some type of neoplastic disease and about one-third had metastases to bone from cancer of various primary sites. There were 15 cases of osteogenic sarcoma and 32 cases of osteitis deformans. All these cases, whether their serum alkaline phosphatase activities were elevated or not, had serum acid phosphatase values that were essentially within the normal range, 0.06-0.89 Bodansky unit for females and 0.11-0.88 unit for males. In contrast to the Gutman method (GIO, G14), there-... 

Transient rises in serum transaminase and serum alkaline phosphatase activities have been observed with aU fluoroquinolones. This occurred in 0.9. 3% of patients in Japan. In the vast majority of the cases this alteration was self-limited and reversible without withdrawal of the drug (42). 

A 56-year-old woman developed chronic biliary ductopenia and portal fibrosis 2 years after a course of terbinafine (42). Terbinafine treatment at that time had resulted in jaundice and evidence of cholestasis. After withdrawal of terbinafine, she continued to have pruritus and persistently raised serum alkaline phosphatase activity. Investigations for various types of chronic liver disease were negative and so chronic bile duct loss and periportal fibrosis were attributed to terbinafine. 

A striking and unexpected outcome of the Cadmibel study was the clear-cut interference of fhe low-level Cd exposure with calcium metabolism. For example, when urinary Cd excretion increased twofold, serum alkaline phosphatase activity and urinary calcium excretion rose by 3-4% and 0.25 mmol/24h respectively [142]. The dose (CdU)-response rate of increased calciuria (>9.8 mmol/24h) suggested a 10% prevalence of hy-percalciuria when CdU exceeded 1.9 pg Cd/24h [38]. Hypercalciuria should be considered an early adverse tubulotoxic effect, because it may exacerbate the development of osteoporosis, especially in the elderly. A prospective study from 1992-1995 (median follow-up of 6.6 years) in the above-mentioned Cadmibel subcohort from the rural area showed for a two-fold increase in urinary Cd a significant (p<0.02) decrease of 0.01 g/ cm in forearm bone density in post-menopausal women. In addition, the relative risks associated with doubled urinary Cd were 1.73 (95% Cl 1.16-2.57 p=0.007) for fractures in women and 1.60 (0.94-2.72 p=0.08) for height loss in men. Cadmium excretion in the four... 

Schlaeger R, Hairs P, Kattermann R. Studies on the mechanism of the increase in serum alkaline phosphatase activity in cholestasis Significance of the hepatic bile acid concentration for the leakage of alkaline phosphatase from rat liver, En2yme 1982 28 3-13. 

From the biochemical point of view, there is merit in measuring the moiety of the serum alkaline phosphatase activity that is inhibited by L-phenylalanine. This moiety is henceforth referred to as LPSAP, L-phenylalanine-sensitive alkaline phosphatase. The conditions to be chosen should provide the maximum expression of LPSAP and the extent of inhibition of intestine and placenta should be as great as possible at a concentration of L-phenylalanine that does not at the same time inhibit... 

Data to be presented in Sections 7.2, 8, and 9.2 were all obtained with the manual method (S49, F14). It is to be expected that these results may differ numerically to some extent from those now being collected in greater numbers with the AutoAnalyzer. Accordingly, Tables 10, 11, 12, and 14 are significant in that they provide an experimental basis for developing the concept of a biochemical pattern for serum alkaline phosphatase activity. The figures (mean SD) will no doubt require revision with the availability of AutoAnalyzer data by the method of Fishman and Green (F8). 

D15. Dijkman, J. H., and Kloppenborg, P. W. C., Increased serum alkaline phosphatase activity in pulmonary infarction. Acta Med. Scand. 180, 273-281 (1966). 

H8. Henneman, P. H., Rourke, G. M., and Jackson, W. P. U., Depression of serum alkaline phosphatase activity by human serum albumin. J. Biol. Chem. 213, 19-25 (1955). 

K27. Kreutz, F. H., Determination of serum alkaline phosphatase activity. Enzymol. Biol. Clin. 6, 185 (1966). 

N4. Nath, R. L., and Ghosh, N. K., A preliminary report on the determination of the normal values of serum alkaline phosphatase activity by velocity constant method. Bull. Calcutta School Trop. Med. 10, 71-72 (1962). 

Schwartz, M. K., Kessler, G., and Bodansky, O., Comparison of serum alkaline phosphatase activities determined with sodium beta glycerophosphate and sodium phenylphosphate as substrates. Am. J. Clin. Pathol. 275-280 (1960). 

Sebesta, D. G., Bradshaw, F. J., and Prockop, D. J., Source of the elevated serum alkaline phosphatase activity in biliary obstruction Studies using isolated liver perfusion. Gastroenterology 47, 166-170 (1964). 

Constancy of Serum Alkaline Phosphatase Activity in Individual Subjects. 176... 

Unexplained High and Low Serum Alkaline Phosphatase Activities. 179... 

Tourniquets do not appear to cause artefactual elevations of serum alkaline phosphatase activities provided the period of venous occlusion does not exceed 30 seconds (S62). Longer periods of occlusion may cause tourniquet effects similar to those seen with protein-bound calcium (R3) and other circulating proteins. This factor may well be responsible for some of the variability between specimens obtained from the same individual at different times (LIO). 

Serum alkaline phosphatase activities of apparently healthy individuals are not evenly distributed about a mean (Fig. 1) but are skewed toward the higher values (ElO, G4, K13, R23). The biological reason for this skewness is not known. Posen (P25) suggested that it may be related to the laws governing the turnover rate of circulating proteins. 

Peak serum alkaline phosphatase activities show a better correlation with sex-maturity ratings than with chronological age (B15). Variations in developmental age may account for some of the differences between the serum alkaline phosphatase values of individual adolescents of the same sex and age (FI 3). 

A steady decline in serum alkaline phosphatase activity toward adult values is seen in late adolescents of both sexes (Fig. 3). This process begins at approximately 11 years of age in females (F13), so that by the time they reach their twentieth year, their levels are almost indistinguishable from those of older females. In males, the decline toward adult values commences later and is more prolonged, so that levels do not merge into those of older adult males until well into the third decade (C22, F13, K23, K33). 

There are now many studies that demonstrate sex- and age-related differences in serum alkaline phosphatase activities in adults, although here, the age-related changes are much less marked than those observed in children. There is general agreement (B37, G4, K23, 05) that up to the age of about 50 years, serum alkaline phosphatase values are higher in males than in females (see Fig. 1). 

The relatively wide variation in serum alkaline phosphatase activities observed in groups of apparently healthy adults (see Table 2) is in sharp contrast to the remarkable constancy of values found over long periods of time in any one subject (Lll, S63, Y3). 

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