Hepatic panel
Alkaline phosphataseALP
Cholestatic and bone marker; isoenzyme separation clarifies origin.
Sample
Serum
Clinical reference range
40 to 130 U/L
Adult
Conv: 40–130 U/L
Biology
What it measures
Membrane-bound enzyme; liver, bone, intestine, placenta isoforms. Induced by biliary obstruction.
Clinical use
Why we order it
Detect cholestasis (with high GGT), bone turnover (Paget, osteomalacia, fractures), pregnancy (placental).
Differential
Causes of abnormal values
Causes of HIGH
- ↑Cholestasis
- ↑Cirrhosis with biliary involvement
- ↑Bone disease
- ↑Pregnancy
- ↑Children/adolescents (growth)
Causes of LOW
- ↓Wilson's disease (low alkaline phosphatase + high bilirubin = ratio <4)
- ↓Zinc deficiency
- ↓Hypothyroidism
- ↓Pernicious anemia
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