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June 1989, Vol 143, No. 6 >
Article | June 1989

Marked Transient Alkaline Phosphatemia Following Pediatric Liver Transplantation FREE

Baburao Koneru, MD; Eduardo Carone, MD; J. Jeffrey Malatack, MD; Carlos O. Esquivel, MD, PhD; Thomas E. Starzl, MD, PhD
[+] Author Affiliations

Accepted for publication December 24, 1988.

Reprints not available.


Am J Dis Child. 1989;143(6):669-670. doi:10.1001/archpedi.1989.02150180047018.
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• An isolated marked transient rise in serum alkaline phosphatase levels in otherwise healthy children is a well-documented occurrence. However, in children undergoing liver transplantation, elevated alkaline phosphatase values raise the possibility of biliary obstruction, rejection, or both. During a 6-year period, 6 of 278 children undergoing liver transplantation exhibited a similar phenomenon as an isolated abnormality. None had rejection, biliary obstruction, or other allograft dysfunction during a long follow-up. Eventually and without intervention, the alkaline phosphatase levels returned to normal. These instructive cases suggest that caution be used in advocating invasive procedures if elevated alkaline phosphatase levels are an isolated abnormality, and close observation with noninvasive testing is recommended.

(AJDC. 1989;143:669-670)

REFERENCES

1 +
Bach U.  Das Verhalten der alkalischen serumphosphatase bei Fruhgeborenen Rachitikern und Spasmophilen . Eur J Pediatr . 1954;;74:593-609.
2 +
Asanti R, Hultim H, Visakorpi JK.  Serum alkaline phosphatase in healthy infants: occurrence of abnormally high values without known cause . Ann Pediatr Fenn . 1966;;12:139-142.
3 +
Posen S, Lee C, Vines R, et al.  Transient hyperphosphatasemia of infancy: an insufficiently recognized syndrome . Clin Chem . 1977;;23:292-294.
4 +
Rosalki SB, Foo Y.  Transient hyperphosphatasemia of infancy: four new cases and a suggested etiology . Clin Chem . 1980;;26:1109-1110.
5 +
Abbasi V, Colon AR, Schwartz RH.  Benign elevation of serum alkaline phosphatase: transient and persistent variety . Clin Pediatr . 1984;;23: 336-337.
6 +
Steinherz PG, Steinherz LJ, Nisselbaum JS, et al.  Transient, marked, unexplained elevation of serum alkaline phosphatase . JAMA . 1984;;252: 3289-3292.
7 +
Kraut JR, Metrick M, Maxwell NR, et al.  Isoenzyme studies in transient hyperphosphatasemia of infancy: ten new cases and a review of the literature . AJDC . 1985;;139:736-740.
8 +
Neale FC, Clubb JS, Posen S.  Artificial elevation of the serum alkaline phosphatase concentration . Med J Aust . 1968;;2:684.
9 +
DeVito GA:  Transient elevation of alkaline phosphatase possibly related to trimethoprim-sulfamethoxazole therapy . J Pediatr . 1982;;100:998-999.

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References

1 +
Bach U.  Das Verhalten der alkalischen serumphosphatase bei Fruhgeborenen Rachitikern und Spasmophilen . Eur J Pediatr . 1954;;74:593-609.
2 +
Asanti R, Hultim H, Visakorpi JK.  Serum alkaline phosphatase in healthy infants: occurrence of abnormally high values without known cause . Ann Pediatr Fenn . 1966;;12:139-142.
3 +
Posen S, Lee C, Vines R, et al.  Transient hyperphosphatasemia of infancy: an insufficiently recognized syndrome . Clin Chem . 1977;;23:292-294.
4 +
Rosalki SB, Foo Y.  Transient hyperphosphatasemia of infancy: four new cases and a suggested etiology . Clin Chem . 1980;;26:1109-1110.
5 +
Abbasi V, Colon AR, Schwartz RH.  Benign elevation of serum alkaline phosphatase: transient and persistent variety . Clin Pediatr . 1984;;23: 336-337.
6 +
Steinherz PG, Steinherz LJ, Nisselbaum JS, et al.  Transient, marked, unexplained elevation of serum alkaline phosphatase . JAMA . 1984;;252: 3289-3292.
7 +
Kraut JR, Metrick M, Maxwell NR, et al.  Isoenzyme studies in transient hyperphosphatasemia of infancy: ten new cases and a review of the literature . AJDC . 1985;;139:736-740.
8 +
Neale FC, Clubb JS, Posen S.  Artificial elevation of the serum alkaline phosphatase concentration . Med J Aust . 1968;;2:684.
9 +
DeVito GA:  Transient elevation of alkaline phosphatase possibly related to trimethoprim-sulfamethoxazole therapy . J Pediatr . 1982;;100:998-999.

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