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HelpTest 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.
Secondary ID
622349Useful 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, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 14 days | |
| Ambient | 7 days | ||
| Refrigerated | 7 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | Reject |
Clinical Information
Alkaline phosphatase (ALP) is present in a number of tissues including liver, bone, intestine, and placenta. The activity of ALP found in serum is a composite of isoenzymes from those sites. Serum ALP is of interest in the diagnosis of hepatobiliary disease and bone disease associated with increased osteoblastic activity.
A rise in liver ALP activity occurs with all forms of cholestasis, particularly with obstructive jaundice.
Bone ALP is elevated in disorders of the skeletal system that involve osteoblast hyperactivity and bone remodeling, such as Paget disease, rickets, osteomalacia, fractures, and malignant tumors.
Moderate elevation ALP may be seen in other disorders such as Hodgkin disease, congestive heart failure, ulcerative colitis, regional enteritis, and intra-abdominal bacterial infections.
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.
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 |