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HelpEpic Test Code LAB741 Alkaline Phosphatase, Total and Isoenzymes, Serum
Additional Codes
MML Code ALKP
Necessary Information
Patient's age and sex are required.
Specimen Required
Patient Preparation: Fasting (8 hours) required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Within 2 hours of collection, centrifuge the specimen.
2. For red top tubes, immediately aliquot into a plastic vial.
3. For serum gel tubes, serum may sit on gel refrigerated but must be aliquoted within 7 days.
Useful For
Aid in the 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 |
| ALPI | Alkaline Phosphatase Isoenzymes, S | No | Yes |
Method Name
ALP: Colorimetric
ALPI: Electrophoresis
Reporting Name
Alkaline Phosphatase, Tot and Iso,SSpecimen Type
SerumSpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Frozen (preferred) | 14 days |
| Ambient | 7 days | |
| Refrigerated | 7 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | Reject |
Clinical Information
Serum alkaline phosphatase (ALP) is used in the diagnosis of hepatobiliary disease and bone disease associated with increased osteoblastic activity. 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.
A rise in liver ALP activity occurs with all forms of cholestasis, particularly with obstructive jaundice.
Bone ALP is 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.
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
Ages:
≤17 years: Refence values have not been established for patients less than 18 years of age.
≥18 years:
Liver %: 30.2-74.7
Liver U/L: 15.8-71.9
Bone %: 23.8-68.3
Bone U/L: 12.0-56.7
Intestine %: ≤22.5
Intestine U/L: ≤12.6
Interpretation
Liver alkaline phosphatase (ALP) isoenzyme is most frequently elevated when total ALP is elevated. Increased liver ALP is associated with a wide group of conditions including acute hepatitis, cirrhosis, fatty liver, drug induced liver disease, obstruction of biliary flow, bile duct stricture, primary biliary cirrhosis, and metastatic carcinoma of the liver.
Bone ALP is elevated due to increased osteoblastic activity. Abnormally elevated bone ALP may be indicative of bone tumors, Paget’s disease, or renal rickets.
Intestinal ALP is detectable in approximately 20% of samples tested. Intestinal ALP is most frequently noted postprandially in patients with blood group O or B.
Cautions
Alkaline phosphatase (ALP) Isoenzyme:
-High concentrations of phosphate, oxalate, citrate, and cyanide will inhibit ALP activity.
-Excess glycine may inhibit ALP activity by complexing magnesium.
-Patients should be fasting. Patients may have an elevated intestinal ALP about two hours after a fatty meal.
Day(s) Performed
Tuesday through Saturday
Report Available
3 to 5 daysSpecimen Retention Time
7 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
84075
84080