Alkaline Phosphatase Isoenzymes
Test Mnemonic
ALKISO
CPT Codes
- 84075 - QTY (1)
- 84080 - QTY (1)
Aliases
- Alkaline Phosphatase Fractionation
Includes
- Intestinal %
- Alkaline Phosphatase
- Bone %
- Liver %
- Bone Fraction
- Liver Fraction
- Intestinal Fraction
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 2 mL | Serum | SST (Gold) | N/A | Refrigerated | Patient should be fasting. Patients who have B or O blood group and are secretors may have an elevated ALP about two hours after a fatty meal. Age and sex of patient are necessary for interpretation of results. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 1.5 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | 24 hours |
| Refrigerated | 7 days |
| Frozen | 14 days |
Days Performed
Varies, Mon - Fri
Turnaround Time
3 - 6 days
Methodology
| Name | Description |
|---|---|
| Electrophoresis |
Reference Range
| Alkaline Phosphatase | |||||
|---|---|---|---|---|---|
| Sex | Age From | Age To | Type | Range | Range Unit |
| Days | 14 Days | Normal | 83 - 248 | U/L | 15 Days | 364 Days | Normal | 122 - 469 | U/L | 1 Years | 9 Years | Normal | 142 - 335 | U/L | 10 Years | 12 Years | Normal | 129 - 417 | U/L | Male | 13 Years | 14 Years | Normal | 116 - 468 | U/L | Male | 15 Years | 16 Years | Normal | 82 - 331 | U/L | Male | 17 Years | 18 Years | Normal | 55 - 149 | U/L | Male | 19 Years | 99 Years | Normal | 38 - 113 | U/L | Female | 13 Years | 14 Years | Normal | 57 - 254 | U/L | Female | 15 Years | 16 Years | Normal | 50 - 117 | U/L | Female | 17 Years | 18 Years | Normal | 45 - 87 | U/L | Female | 19 Years | 99 Years | Normal | 34 - 123 | U/L |
| Bone % | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 10.7-68.3 | % | |||
| Bone Fraction | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 12.9-52.6 | U/L | |||
| Intestinal % | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 0.0-24.2 | % | |||
| Intestine Fraction | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 0.0-16.3 | U/L | |||
| Liver % | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 26.0-86.2 | % | |||
| Liver Fraction | |||||
| Sex | Age From | Age To | Type | Range | Range Unit |
| Normal | 16.0-69.3 | U/L |
Clinical Info
When the Total Alkaline Phosphatase activity is increased, the Isoenzymes are useful in determining the source of the increased activity. Macrohepatic isoenzyme of alkaline phosphatase can be seen in the context of viral hepatitis, alcoholic cirrhosis, metastatic liver disease, and other liver diseases. It may also occasionally be seen in healthy individuals. Clinical correlation is required.
Clinical Limitation
High concentrations of phosphate, oxalate, citrate and cyanide will inhibit alkaline phosphatase (ALP) activity. Excess glycine may inhibit ALP activity by complexing Mg2+. EDTA inhibits some of the isoenzymes of ALP. Do not use as an anticoagulant. Several drugs cause an enzymatic imbalance which may change the ALP level.