ALKALINE PHOSPHATASE

Males : 53 – 128 U/L

Females : 42 -98 U/L

Infants : 150 – 420 U/L Children : 100 -320 U/L

• Alkaline phosphatase is an enzyme in all tissues. Tissues with particularly high concentrations include liver, bile ducts, placenta and bone. ALP is one of the enzymes present in serum that is capable of transporting phosphate groups across cell membrane.
• The serum or plasma ALP is estimated to investigate diseases of the liver or bone, especially in cases of biliary obstruction, tumors, hydatid cyst and abscesses. Since damaged or diseased tissue releases enzymes to the blood ,serum ALP measurements can be abnormal in many conditions, including bone disease and liver disease.
• ALP is a marker for biliary dysfunction. The values are increased:
• Greater than twice the normal in complete obstructive cholestasis in proportion to increase in serum bilirubin. 
• More than 10 times if infection supervenes in the case of complete biliary obstruction.
• It is normal for young children experiencing rapid growth and for pregnant women to have high levels of ALP. Any condition causing excessive bone formation, including bone disorders such as Paget’s disease can cause increased ALP levels.
•  If it is not apparent from clinical s/s whether the source of a high ALP test result is from liver or bone disease, then a test may be performed to determine which isoenzyme is increased in the blood.

• when there is s/s suggesting a bone disorder (Bone and or joint pain, Increased frequency of fractures , Deformed bones).
• When there is Symptoms of Bile duct obstruction (Severe abdominal pain in the right upper quadrant or center of abdomen , pain that spreads to the back or right shoulder blade , Nausea , Abdominal pain linked with eating a fatty meal).
• When there is s/s of liver disease ( weakness, fatigue, loss of appetite, nausea, vomiting, Jaundice, Dark urine, light coloured stools, pruritus, swelling in the legs and ankles, tendency to bruise easily)

• Biliary obstruction
• Bone disease
• Healing fracture 
• Hepatitis
• Hyperthyroidism
• Hyperparathyroidism
• Leukemia
• Liver diseases
• Cirrhosis 
• Gilbert syndrome
• Fatty metamorphosis of liver
• Sepsis
• infectious mononucleosis
• cytomegalovirus infections
• Postoperative cholestasis
• Pancreatitis
• carcinoma of pancreas,cystic fibrosis
• Anaemia 
• Pulmonary infarct
• Fanconi syndrome
• Osteoblastic bone cancers
• Osteomalacia
• Paget's disease
• Rickets
• Hypervitaminosis D
• Familial hyperphosphatasemia

• Malnutrition
• Protein deficiency
• Pernicious anemia
• Hypophosphatasia
• Hypothyroidism
• Severe chronic nephritis 
• Celiac disease