Cause of elevated alk phos. in bloodwork?

Nurses General Nursing

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I was wondering if anyone could help explain what the causes of elevated alk phos only (all other BW results normal) would be? I would think it would be liver damage but all other enzymes are WNL.

Specializes in Emergency, Outpatient.

Cancer in the bone, gallbladder disease, normally elevated with rapid bone growth, hepatitis, mono, gosh there are lots of reasons, parasites etc.

I was wondering if anyone could help explain what the causes of elevated alk phos only (all other BW results normal) would be? I would think it would be liver damage but all other enzymes are WNL.

Alk phos is an enzyme that is found in all tissue. It has higher concentration in bone, bile duct and placenta. Serum Alk phos is mostly bone and hepatic (although a good percentage is probably intestinal). The most common cause of an isolated Alk Phos would be medications. There is a long list of medications that can cause elevated Alk phos. An isolated continued elevated Alk phos can suggest either liver, bone or pregnancy. You can sometimes differentiate liver Alk phos by looking for a high GGT. Getting Isoenzymes will help differentiate between liver and bone. Looking for pregnancy should be obvious. It is also rarely seen in IBD. Finally 20-30% of elevated Alk phos will have no obvious cause (probably familial).

David Carpenter, PA-C

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