Benign transient hyperphosphatasemia in infants and children: a prospective cohort

Teitelbaum, Jonathan E.; Laskowski, Alexandra; Barrows, Frank

doi:10.1515/jpem.2011.077

Cited by 18 publications

(25 citation statements)

References 12 publications

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“…The prevalence of TH is reported to be 1.5% up to 5.1% during infancy but the real incidence of TH is not known certainly, because ALP levels is not routinely determined in benign conditions [5,7,8,11]. Although, in most of studies, TH affects both sexes equally [8,11], similar like our study, Carroll et al documented a significant male predominance [6].…”

Section: Discussionsupporting

confidence: 72%

“…Characteristic features of TH previously have been described by Kraut et al [3], include; a) elevation of serum ALP b) no signs of liver, metabolic or bone disease c) age of less than 5 years d) return to normal serum ALP levels within 4 months. The prevalence of TH ranged 1.5 to 5.1 % in infancy, so recognition of this entity is important to avoid unnecessary tests [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Transient hyperphosphatasemia in infants and children: a retrospective study of 43 cases

Çakır

Kırşaçlıoğlu

Tartıcı

et al. 2017

Journal of Contemporary Medicine

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Objective: To describe the prevalence and clinical characteristics of elevated plasma ALP levels during a period of 3 years at our clinic.Material and Methods: We reviewed 533 children, retrospectively, to investigate the frequency, seasonal fluctuation, age distribution, and sex differences of the patients with the elevated ALP levels in younger than 5 years old children.Results: Twenty-four of the patients were girls (55.8%), and the mean age of the patients was 7.48±12.77 (1-60) months. The mean serum alkaline phosphatase (ALP) level was 1402.23 ± 440.4 U/L (1038-3135 U/L) and it was 3.33±1.04 (2.47-7.46) fold above upper range. Their ALP levels returned to normal in a mean period of 2.5 ± 1.1 (1 to 5) months.Conclusion: Early recognition of this benign entity, should help to avoid unnecessary tests.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Transient hyperphosphatasemia in infants and children: a retrospective study of 43 cases

Çakır

Kırşaçlıoğlu

Tartıcı

et al. 2017

Journal of Contemporary Medicine

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“…This is why the isoenzymes test was only performed in 2 of 5 patients, in which, according to expectations, bone predominated over liver elevation. Although this is another criteria defined by Kraut, recent articles argue its value to confirm the diagnosis 11 ; Teitelbaum et al, in a prospective cohort study of 20 children with severe ALP increase and without evident disease, performed clinical follow-up and retest of ALP within 2 to 3 months without additional tests, demonstrating that the increase and subsequent regression of ALP (meeting Kraut's other criteria) are enough elements 12 .…”

Section: Discussionmentioning

confidence: 99%

Hiperfosfatasemia transitoria benigna de la infancia, Serie Clinica

Rocha

2016

Revista Chilena de Pediatría

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Introduction: Alkaline Phosphatase (ALP) is a group of 4 isoenzymes produced in different tissues. Elevated levels of ALP can be developed under physiological conditions, and can indicate the presence of bone or hepatobiliary diseases. In children, one of its most common harmless causes is benign transient hyperphosphatasemia (BTH), a little known condition. The objective is to report BTH cases and propose a monitoring plan. Case reports: The cases of 5 children aged between 11 and 50 months are presented, 4 of them female, with the incidental finding of a sudden and severe ALP elevation (> 1,000 U/l), in tests ordered due to either abnormal growth and development, or intercurrent infections. Bone and liver disease were ruled out using the patient history, physical examination and basic laboratory results. Isoenzymes levels were determined in 2 patients. A return to normal ALP levels was observed over a period of 1-6 months, with no evidence of further complications. Conclusion: BTH is a benign self-limiting biochemical disorder, which should be considered in children under 5 years old with severe ALP elevation in the absence of clinical or laboratory abnormalities suggestive of bone or liver disease.

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“…These isoenzymes hydrolyze organic phosphate esters at an alkaline pH to form phosphate and an organic radical. 1 The two isoenzymes that predominate in healthy children originate mainly in bone and the liver. The bone isoenzyme contributes 85% of the serum ALP and the liver isoenzyme 15%.…”

Section: Epidemiologic and Clinical Datamentioning

confidence: 99%

“…1,2 Despite the criteria shown in Table 1, there are studies 8 describing patients older than age 5 years, and approximately 25% of published cases occurred in children age 37 months or older or in adults. The normalization period of the elevated serum ALP was more than 17 weeks in approximately 20% of the published cases.…”

Section: 5mentioning

confidence: 99%

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

Shapira¹,

Shaoul²

2015

Pediatr Ann

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A n 18-month-old boy presented to his primary care pediatrician with a complaint of diarrhea for the past 5 days. The diarrhea was frequent, watery, but without mucus or blood. The diarrhea was not associated with vomiting, fever, cough, or skin rash. His past medical history is significant only for mild asthma, and his immunizations are up-to-date.The physical examination revealed an alert, well-developed boy with a weight of 11.9 kg (54th percentile), height of 84.5 cm (77th percentile), and normal vital signs. His abdomen was soft, nontender, and without hepatosplenomegaly or signs of dehydration. The rest of the physical examination was normal.A clinical diagnosis of viral gastroenteritis was made and oral rehydration therapy and dietary modifications were recommended. After 3 days he returned to the clinic because of the persistence of the diarrhea, and there were still no other symptoms. Once again, the results of his physical examination were normal. Because of the continuation of the diarrhea, laboratory tests (blood, urine, and stool) were performed, and the results were as follows: hemoglobin, 11.5 g/dL; white blood cells, 9.2 10 3 /mcL; platelets, 367 10 3 /mcL (with a normal differential count); C-reactive protein, <0.5 mg/dL; glucose, 75 mg/dL; urea, 25 mg/dL; creatinine, 0.20 mg/dL; potassium, 4.3 nmol/L; sodium, 138 nmol/L; protein, 6.2 g/dL; albumin, 4.1 g/dL; bilirubin, 0.20 mg/dL; ferritin, 20 ng/mL; asparate aminotransferase, 37 U/L; alanine aminotransferase, 26 U/L; gamma-glutamyl transpeptidase, 5 U/L; calcium, 9.3 mg/dL; and phosphorus, 4.9 mg/dL. Urinalysis was normal, and stool for culture, ova, parasites, Giardia lamblia antigen, rotavirus, and adenovirus was negative. Blood serology was negative for Epstein-Barr virus (EBV), hepatitis C, and for immunoglobulin M cytomegalovirus (CMV) antibodies, and positive for immunoglobulin G CMV antibodies, indicating a past infection with CMV.An elevated biochemical parameter in the blood revealed a condition that may be associated with the clinical presentation (gastroenteritis) described, appearing mainly in infancy and early childhood.

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Benign transient hyperphosphatasemia in infants and children: a prospective cohort

Cited by 18 publications

References 12 publications

Transient hyperphosphatasemia in infants and children: a retrospective study of 43 cases

Transient hyperphosphatasemia in infants and children: a retrospective study of 43 cases

Hiperfosfatasemia transitoria benigna de la infancia, Serie Clinica

An 18-Month-Old Boy with Diarrhea and an Elevated Biochemical Parameter

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