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Test Code ALPI Alkaline Phosphatase Isoenzymes, Serum


Specimen Required


Only orderable as part of a profile. For more information see ALKP / Alkaline Phosphatase, Total and Isoenzymes, Serum.

 

Patient Preparation: Fasting (8 hours) required

Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 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.


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

Method Name

Only orderable as part of a profile. For more information see ALKP / Alkaline Phosphatase, Total and Isoenzymes, Serum.

 

Electrophoresis

Reporting Name

Alkaline Phosphatase Isoenzymes, S

Specimen Type

Serum

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Frozen (preferred) 14 days
  Ambient  7 days
  Refrigerated  7 days

Reference Values

Only orderable as part of a profile. For more information see ALKP / Alkaline Phosphatase, Total and Isoenzymes, Serum.

 

Ages:

≤17 years: Reference values have not been established for patients younger than 18 years.

≥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 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.

Clinical Reference

1. Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics 6th ed. Elsevier; 2018

2. Lowe D, Sanvictores T, John S. Alkaline phosphatase. In: StatPearls [Internet]. StatPearls Publishing; 2021. Updated October 29, 2023. Accessed November 12, 2024. Available at www.ncbi.nlm.nih.gov/books/NBK459201

3. Teitelbaum JE, Laskowski A, Barrows FP. Benign transient hyperphosphatasemia in infants and children: a prospective cohort. J Pediatr Endocrinol Metab. 2011;24(5-6):351-353

4. Jassam NJ, Horner J, Marzo-Ortega H, et al. Transient rise in alkaline phosphatase activity in adults. BMJ Case Rep. 2009;2009:bcr09.2009.2250

5. Verma J, Gorard DA. Persistently elevated alkaline phosphatase. BMJ Case Reports 2012;10.1136/bcr-2012-006768

6. Sharma U, Pal D, Prasad R. Alkaline phosphatase: An overview. Indian J Clin Biochem. 2014;29(3):269-278

Day(s) Performed

Tuesday through Saturday

Report Available

3 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84080

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ALPI Alkaline Phosphatase Isoenzymes, S 12805-8

 

Result ID Test Result Name Result LOINC Value
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