Isoenzyme characterization in isolated elevation of alkaline phosphatase after liver transplantation in children.
BACKGROUND
Isolated transient elevation of alkaline phosphatase (ALP) in the absence of bone or liver disease has been reported in children including liver transplant patients. Specific isoenzyme patterns have been associated with this phenomenon in healthy children but have not been reported after liver transplantation. The discovery of the isoenzyme pattern associated with benign transient hyperphosphatasemia in one child prompted a study of all our posttransplant patients.


METHODS
Retrospective analysis of ALP isoenzymes by polyacrylamide gel electrophoresis on banked serum samples.


RESULTS
The incidence of isolated transient hyperphosphatasemia was 4.3%. All 11 children demonstrated the isoenzyme pattern associated with benign transient hyperphosphatasemia. In one child, the hyperphosphatasemia occurred on a background of chronic cholangiopathy and in a second, shortly after an episode of probable cytomegalovirus hepatitis.


CONCLUSIONS
Isolated elevation of serum ALP after liver transplantation in children is common. Analysis of ALP isoenzymes, looking for the pattern of benign transient hyperphosphatasemia, can assist in the management of these children.
O'Riordan
Sean
S
Wellcome Trust Clinical Research Unit, Centre for Tropical Diseases, Ho Chi Minh City, Viet Nam.
Baker
Alastair J
AJ
Sherwood
Roy A
RA
D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood*; D001649:Bile Duct Diseases / Q000097:blood; D002648:Child; D003586:Cytomegalovirus Infections / Q000821:virology; D005260:Female; D006525:Hepatitis, Viral, Human / Q000097:blood / Q000150:complications; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D016031:Liver Transplantation; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors
D007527:Isoenzymes; D000469:Alkaline Phosphatase