Transient hyperphosphatasemia in children revisited

• Published in: Pediatrics international Vol. 52; no. 6; pp. 866 - 871
• Main Authors: Dori, Neta, Levi, Lily, Stam, Tamar, Sukhotnik, Igor, Shaoul, Ron
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.12.2010; Blackwell Publishing Ltd
• Subjects: Age Factors; alkaline phosphatase; Alkaline Phosphatase - blood; Asthma - diagnosis; Asthma - enzymology; Bacterial Infections - diagnosis; Bacterial Infections - enzymology; child; Child, Preschool; Developmental Disabilities - diagnosis; Developmental Disabilities - enzymology; Diarrhea, Infantile - diagnosis; Diarrhea, Infantile - enzymology; Enzymes; Failure to Thrive - diagnosis; Failure to Thrive - enzymology; Feeding and Eating Disorders - diagnosis; Feeding and Eating Disorders - enzymology; Female; gamma-Glutamyltransferase - blood; Humans; Infant; isoenzyme; Isoenzymes - blood; Male; Medical diagnosis; Metabolic disorders; Pediatrics; Reagent Kits, Diagnostic; Reference Values; Retrospective Studies; Risk Factors; Seasons; Sex Factors; Virus Diseases - diagnosis; Virus Diseases - enzymology
• ISSN: 1328-8067; 1442-200X; 1442-200X
• DOI: 10.1111/j.1442-200X.2010.03265.x

Objective:  Although transient hyperphosphatasemia (TH) has been well known for decades, its etiology and pathophysiology remain unclear. We aimed to study the clinical characteristics of children diagnosed with TH compared to older studies in order to expand our knowledge and understanding of this condition and to try and find a subgroup of children who are more prone to develop TH. Methods:  We retrospectively studied 60 children diagnosed at Maccabi Health Services and Bnai Zion Medical Center, Haifa, Israel with TH between the years 2003–08. One hundred and twenty‐two children matched by age, gender and presenting symptoms served as the control group. The patients were divided into four subgroups by their presenting symptoms: infectious disease 33%, failure to thrive 28%, diarrhea 15% and other 23%. The Hydragel 7 ISO‐PAL® and Hydragel 15 ISO‐PAL® kits were used for the identification and quantification of ALP isoenzymes in human serum. Results:  The ALP levels of the study group were 805–8619 U\L (mean 2311 U\L), without differences between the subgroups. The mean duration of TH was 12 weeks. ALP isoenzymes levels were measured in one‐third of the patients, and showed that the bone isoenzyme was elevated in most. Forty‐three (71%) subjects were diagnosed in the second half of the calendar year. Conclusions:  We could not establish an etiological explanation for TH. We presume that it is a complex mechanism in which different stimuli led to upregulation of the enzyme.