All issues > Volume 48(3); 2005

Original Article

Korean J Pediatr. 2005;48(3):306-309. Published online March 15, 2005.

Benign Transient Hyperphosphatasemia of Infancy and Childhood

Jung Hyun JH Kwon¹, Ji Hye JH Park¹, Hae Soon HS Kim¹, Seung Joo SJ Lee¹, Mi Ae MA Lee²

¹Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Korea
²Department of Laboratory Medicine, College of Medicine, Ewha Womans University, Seoul, Korea

Correspondence Hae Soon HS 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.

Keywords :Alkaline phosphatase , Benign transient hyperphosphatasemia