Alkaline Phosphatase Isoenzymes

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Alkaline Phosphatase Isoenzymes

 Alkaline Phosphatase [ALP] is an enzyme that is found in different body parts such as liver, bones, bile ducts and intestines. Different forms of the ALP are called isoenzymes and their structure depends on the location in the body where they are produced.

What is ALP Isoenzyme test?15

 An ALP test detects the level of ALP in the blood. High levels of ALP would indicate bone or liver disorders.

When ALP test results are high, an ALP Isoenzyme test is performed to determine the part of the body causing high levels of ALP. It is performed to detect bone disorders such as bone cancers, osteoporosis, or Paget’s disease (a condition which causes malformed bones) and liver diseases such as liver cancer and hepatitis.

It is also performed to monitor treatment for different bone and liver diseases.

Why is ALP Isoenzyme test suggested?1

 This test is ordered if the doctor feels you might be having a bone or liver disease when the following symptoms show:

  • Bone/joint pain.
  • Deformed bones/brittle bones.
  • Increased occurrence of fractures.
  • Weakness, fatigue, loss of appetite, nausea, or vomiting.
  • Abdominal swelling or pain.
  • Jaundice.

Dark urine or light-coloured stool.

How is ALP Isoenzyme test performed?12

 An ALP Isoenzyme test is a blood test. The nurse/lab technician rinses the skin with an alcohol pad, inserts a needle into a vein on the rinsed skin, draws the blood and stores it in a small vial. You may feel a slight pinch. The nurse will place a dressing strip on the skin immediately after the process.

 The blood sample is sent to the laboratory for diagnosis. The blood sample is taken from a vein visible on the inside of the elbow or the back of the hand.

What are the parameters measured in ALP Isoenzyme test? 23

Higher than normal ALP levels indicate:

  • Osteoblastic bone tumours.
  • Rickets or osteomalacia.
  • Osteoporosis.
  • Paget’s disease.
  • Hyperparathyroidism or leukaemia which affect the bones.
  • Biliary obstruction.
  • Hepatitis.
  • Lymphoma.
  • Sarcoidosis.
  • Liver diseases or liver cancer
  • Vitamin D deficiency.

Lower than normal ALP levels indicate:

  • Malnutrition.
  • Anaemia.
  • Wilsons disease.
  • Hypophosphatasia.
  • Protein deficiency.

Preparation before performing ALP Isoenzyme test 35

You should not eat or drink anything 6 hours before the test, unless stated otherwise by your doctor.

 Your doctor might ask you to stop taking any medicines before the test as they may interfere with the test result. Consult your doctor before taking any medicines before the test.

Post-care after ALP Isoenzyme test 

 An ALP Isoenzyme test does not completely diagnose a disease. It only narrows down the source of increased ALP level. Further tests need to be performed to confirm the kind of disease you have.


Side effects/risks of ALP Isoenzyme test 

 Side effects of the blood test might include:

  • Bleeding.
  • Discomfort.
  • Swelling.
  • Slight bruising or throbbing on the needle site.

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