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Test Code ALKI Alkaline Phosphatase, Total and Isoenzymes, Serum

Reporting Name

Alkaline Phosphatase, Tot and Iso,S

Useful For

Diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases

 

Determining the tissue source of increased alkaline phosphatase (ALP) activity in serum

 

Differentiating between liver and bone sources of elevated ALP

Profile Information

Test ID Reporting Name Available Separately Always Performed
ALP Alkaline Phosphatase, S Yes Yes
ALKE Alkaline Phosphatase Isoenzymes, S No Yes

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Necessary Information


Patient's age and sex are required.



Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL, divided

Collection Instructions: Centrifuge and aliquot serum into 2 tubes, each containing 0.5 mL


Specimen Minimum Volume

0.5 mL divided into 2 tubes each containing 0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 14 days
  Ambient  7 days
  Refrigerated  7 days

Reference Values

ALKALINE PHOSPHATASE

Males

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 116-468 U/L

15-<17 years: 82-331 U/L

17-<19 years: 55-149 U/L

≥19 years: 40-129 U/L

Females

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 57-254 U/L

15-<17 years: 50-117 U/L

≥17 years: 35-104 U/L

 

ALKALINE PHOSPHATASE ISOENZYMES

Liver 1%

0-6 years: 5.1-49.0%

7-9 years: 3.0-45.0%

10-13 years: 2.9-46.3%

14-15 years: 7.8-48.9%

16-18 years: 14.9-50.5%

≥19 years: 27.8-76.3%

Liver 1

0-6 years: 7.0-112.7 IU/L

7-9 years: 7.4-109.1 IU/L

10-13 years: 7.8-87.6 IU/L

14-15 years: 10.3-75.6 IU/L

16-18 years: 13.7-78.5 IU/L

≥19 years: 16.2-70.2 IU/L

Liver 2%

0-6 years: 2.9-13.7%

7-9 years: 3.7-12.5%

10-13 years: 2.9-22.3%

14-15 years: 2.2-19.8%

16-18 years: 1.9-12.5%

≥19 years: 0.0-8.0%

Liver 2

0-6 years: 3.0-41.5 IU/L

7-9 years: 4.0-35.6 IU/L

10-13 years: 3.3-37.8 IU/L

14-15 years: 2.2-32.1 IU/L

16-18 years: 1.4-19.7 IU/L

≥19 years: 0.0-5.8 IU/L

Bone %

0-6 years: 41.5-82.7%

7-9 years: 39.9-85.8%

10-13 years: 31.8-91.1%

14-15 years: 30.6-85.4%

16-18 years: 38.9-72.6%

≥19 years: 19.1-67.7%

Bone

0-6 years: 43.5-208.1 IU/L

7-9 years: 41.0-258.3 IU/L

10-13 years: 39.4-346.1 IU/L

14-15 years: 36.4-320.5 IU/L

16-18 years: 32.7-214.6 IU/L

≥19 years: 12.1-42.7 IU/L

Intestine %

0-6 years: 0.0-18.4%

7-9 years: 0.0-18.3%

10-13 years: 0.0-11.8%

14-15 years: 0.0-8.2%

16-18 years: 0.0-8.7%

≥19 years: 0.0-20.6%

Intestine

0-6 years: 0.0-37.7 IU/L

7-9 years: 0.0-45.6 IU/L

10-13 years: 0.0-40.0 IU/L

14-15 years: 0.0-26.4 IU/L

16-18 years: 0.0-12.7 IU/L

≥19 years: 0.0-11.0 IU/L

Placental

Not present

Day(s) Performed

Monday through Friday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84075

84080

Clinical Information

Alkaline phosphatase (ALP) is present in a number of tissues including liver, bone, intestine, and placenta. The activity of ALP found in serum is a composite of isoenzymes from those sites and, in some circumstances, placental or Regan isoenzymes. Serum ALP is of interest in the diagnosis of 2 main groups of conditions: hepatobiliary disease and bone disease associated with increased osteoblastic activity.

 

A rise in ALP activity occurs with all forms of cholestasis, particularly with obstructive jaundice. The response of the liver to any form of biliary tree obstruction is to synthesize more ALP. The main site of new enzyme synthesis is the hepatocytes adjacent to the biliary canaliculi.

 

ALP is also elevated in disorders of the skeletal system that involve osteoblast hyperactivity and bone remodeling, such as Paget disease, rickets, osteomalacia, fractures, and malignant tumors.

 

Moderate elevation of ALP may be seen in other disorders such as Hodgkin disease, congestive heart failure, ulcerative colitis, regional enteritis, and intra-abdominal bacterial infections.

Report Available

2 to 5 days

Reject Due To

Gross hemolysis Reject
Gross lipemia OK
Gross icterus OK

Method Name

ALP: Colorimetric

ALKE: Electrophoresis