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Malignancies resulting in expression of ALP-like gene eg. Alkaline phosphatase is an enzyme.
During pregnancy alkaline phosphatase may reach three times the upper normal limit.
Alkaline phosphatase raised in pregnancy. Elevation of alkaline phosphatase level according to the gestational age. ALP is an enzyme produced by liver bones kidneys small intestine and placenta. In a pregnant patient elevation of ALP may be related to HELLP syndrome intrahepatic cholestasis malignancy and liver or bone diseases.
Although obstetricians have observed elevations in serum alkaline phosphatase ALP during pregnancy these typically are not much more than twice the pre-pregnancy upper limit of normal. There is currently a paucity of cases in which exaggerated increases are observed. Seeing an atypically elevated value can be distressing to both the clinician and the patient especially when it is.
During the eighteen months following delivery the mean serum alkaline phosphatase activities were significantly raised. Increase in plasma volume which occurs during pregnancy is suggested as the cause of the fall in serum enzyme activity in the second trimester whereas the rise in enzyme activity in the third trimester is attributed to the well-known increase in serum alkaline phosphatase of. In a pregnant patient elevation of ALP may be related to HELLP syndrome intrahepatic cholestasis malignancy liver or bone diseases.
However a placental origin of ALP must be explored. ALP is physiologically produced by placenta at the brush border membranes of the syncytiotrophoblast. During pregnancy alkaline phosphatase may reach three times the upper normal limit.
An abnormally elevated or rising alkaline phosphatase may be a marker of placental dysfunction. In cases with an abnormally elevated alkaline phosphatase more frequent monitoring may be indicated. If alkaline phosphatase is raised in an asymptomatic patient and serum bilirubin liver transaminases creatinine adjusted calcium thyroid function and blood count are normal.
Consider growth spurts in adolescents pregnancy in women drugs and age related increases As. Suggested and raised levels indicate a hepatic rather than bone origin. An isolated raised ALP typically indicates a bone origin therefore we suggest to follow-up with bone profile and PTH particularly if the patient has a normal gamma-GT level.
We suggest using the. During pregnancy the placenta secretes its own isoenzyme which raises total alkaline phosphatase concentration. Malignancies resulting in expression of ALP-like gene eg.
In determining whether a raised ALP is of hepatic or bony origin eg. In metastasis of breast cancer the following may be useful. Other test of hepatic function eg.
Electrophoresis separation of isoenzymes. Raised alkaline phosphatase in pregnancy. Pages with alkaline in the title are.
Asymptomatic raised alkaline phosphatase. Alkaline phosphatase raised related to medication drug-induced alkaline phosphatase raised drug induced raised alk pho alkaline phosphatase neutrophil alkaline phosphatase reduced drugs causing raised alkaline. Some causes of elevated alkaline phosphatase include Paget disease healing fractures acromegaly osteogenic sarcoma liver or bone metastases leukemia myelofibrosis rickets osteomalacia hypervitaminosis D cholestasis of pregnancy biliary obstruction hyperthyroidism infiltrative liver diseases eg sarcoid TB amyloidosis abscess.
Early elevated alkaline phosphatase increases the risk of large-for-gestational-age birth weight in pregnant women with normal glucose tolerance A significantly increased risk of LGA was associated with higher serum concentrations of ALP in pregnant women with NGT even it is in normal reference range. What Is Alkaline Phosphatase. Alkaline phosphatase is an enzyme.
An enzyme is a type of protein that catalyzes causes or accelerates chemical reactions in the body. ALP is produced mainly by the liver and bones but is also synthesized in smaller quantities by the intestines and kidneys. ALP is also secreted from the placenta during pregnancy.
Alkaline phosphatase is produced by the placenta. High levels occur in pregnancy and the normal reference ranges do not then apply. No reference ranges exist for pregnancy - levels will be dependent on size of the placenta.
Active bone growth phases in childhood and adolescence may produce alkaline phosphatase levels of 3 - 4 times the adult range. Pregnancy- The placenta at the beginning of the third trimester produces high levels of alkaline phosphatase enzymes. It tends to increase the maternal values beyond their normal range.
The increase is important in the synthesis of proteins calcification of the cartilage and the bones. It stays for some time after birth. Serum alkaline phosphatase activity increases in late pregnancy due both to the production of the placental isoenzyme and to the increase in bone isoenzyme.
Consequently measurement of serum alkaline phosphatase levels is not a suitable test for the diagnosis of cholestasis during pregnancy.