title: Positive placental staining for alkaline phosphatase corresponding with extreme elevation of serum alkaline phosphatase during pregnancy.
abstract: Placental ALP (ALP(h)) is a membrane-anchored, heat-stable enzyme produced by the syncytiotrophoblast. We report a case of a patient presenting in the third trimester with extreme increased levels of ALP(h). A 40-year-old woman, gravida 2, para 1, was admitted to the high risk pregnancy unit at 30 weeks of gestation for evaluation of an incidental finding of marked isolated elevation in serum ALP(h). Blood tests obtained at admission revealed a marked elevation of serum ALP level up to 1,194 u/l (reference 35-104 u/l). At 36 weeks of gestation, the patient was admitted with preterm premature rupture of membranes. Due to breech presentation, a cesarean delivery was performed. An immunoperoxidase stain was done for placental alkaline phosphatase, which was positive in the majority of chorionic trophoblastic cells. No evidence of inflammation was detected in the placental chorionic plate. Thus, isolated elevation in placental ALP may be linked to a subsequent preterm delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Be'er-Sheva, Israel. abashiri@bgumail.bgu.ac.il
authors.forename: Asher
authors.initials: A
authors.lastname: Bashiri
authors.forename: Ohad
authors.initials: O
authors.lastname: Katz
authors.forename: Esther
authors.initials: E
authors.lastname: Maor
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.forename: Izak
authors.initials: I
authors.lastname: Pack
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000032:analysis* / Q000097:blood; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000097:blood*; D006801:Humans; D010920:Placenta / Q000737:chemistry*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000097:blood*
chemical_list: D000469:Alkaline Phosphatase