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Test Code LAB741 Alkaline Phosphatase, Total and Isoenzymes, Serum

Additional Codes

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.


Secondary ID

622157

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

Specimen Type

Serum

Specimen 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

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.

Method Description

Total Alkaline Phosphatase:

In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase (ALP) activity. It is determined by measuring the increase in absorbance.(Package insert: Alkaline Phosphatase reagent. Roche Diagnostics; V 9.0 10/2021)

 

Alkaline phosphatase Isoenzymes:

Alkaline phosphatase isoenzymes are separated by agarose gel electrophoresis and visualized using BCIP (5-Bromo-4-chloro-3-indolyl phosphate p-toluidine salt) substrate.(Package insert: SPIFE Touch Alkaline Phosphatase [ALP] Isoenzyme. Helena Laboratories; 02/2017)

Day(s) Performed

Tuesday through Saturday

Report Available

3 to 5 days

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

84075

84080

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ALKP Alkaline Phosphatase, Tot and Iso,S 24332-9

 

Result ID Test Result Name Result LOINC Value
ALP Alkaline Phosphatase, S 6768-6
622367 Alkaline Phosphatase Isoenzymes, S 12805-8
622369 Liver Percent 15015-1
622368 Liver 1779-8
622371 Bone Percent 15013-6
622370 Bone 1777-2
622373 Intestine Percent 15014-4
622372 Intestine 1778-0