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Benign Transient Hyperphosphatasemia of Infancy and Childhood

Korean Journal of Pediatrics 2005;48(3):306-309.
Published online March 15, 2005.
Benign Transient Hyperphosphatasemia of Infancy and Childhood
Jung Hyun Kwon1, Ji Hye Park1, Hae Soon Kim1, Seung Joo Lee1, Mi Ae Lee2
1Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
2Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
소아기 일과성 고포스파타아제혈증 (Hyperphosphatasemia)에 대한 임상고찰
권정현1, 박지혜1, 김혜순1, 이승주1, 이미애2
1이화여자대학교 의과대학 소아과학교실
2이화여자대학교 의과대학 진단검사의학교실
Correspondence: 
Hae Soon Kim, Email: hyesk@ewha.ac.kr
Abstract
Purpose
: The aim of study is to investigate the clinical manifestations and the etiology of markedly-elevated serum alkaline phosphatase(ALP) levels in children without accompanying liver or bone disease.
Methods
: The serum ALP and other biochemical laboratory data of 4,989 patients attending the pediatric department of Ewha Womans University Mokdong Hospital between January 2002 to December 2002 were studied. The subjects' ages ranged from 4 months to 14 years. Among them, serum ALP levels were markedly elevated over 1,000 IU/L in 114 children. Among those 114 children, 97 children without liver or bone disease were reviewed retrospectively.
Results
: Of the 114 children with serum ALP activity of over 1,000 IU/L, 97(85.8 percent) children had neither liver or bone disease. The average ALP activity level was 1,539±948 IU/L. The male : female ratio was 1 : 0.7. Forty-four children(45.3 percent) were between 4 months to 1-year-old, 19 children(19.3 percent) were between 1- to 2-year-old. We observed a seasonal clustering of cases in during October with 10 cases(10.2 percent) and in during December with 11 cases(11.3 percent). The most common clinical presentation was respiratory tract infection in 25 cases(26.9 percent), and acute gastroenteritis in 17 cases(17.5 percent). Forty-four cases had follow-up ALP activity level, 1 month later and the activity decreased under 1,000 IU/L in 37 cases(84 percent).
Conclusion
: Hyperphosphatasemia is a benign and transient phenomenon. If there are no clinical and laboratory abnormalities of liver and bone, we suggest monitoring monitor the high serum ALP level 1 month later. If decreased, it seems that it is not necessary for specific examinations to exclude other diseases of malignant condition.
Key Words: Alkaline phosphatase , Benign transient hyperphosphatasemia


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