Isolated elevation of serum alkaline phosphatase and biliary disease in the elderly

Abstract

Disease presentation is commonly non-specific in the geriatric age group. An isolated elevation of serum alkaline phosphatase concentration may be the only pointer to underlying biliary disease.

Value of profiling liver function in the elderly

“…In this series, gall stone disease was suspected clinically in four patients and indicated by profiling tests in eight cases. A raised serum AP level may be the only marker of gall stone disease (Jones et al, 1982). In a large series of elderly patients with choledochal stones, 10% presented with elevation of this enzyme without jaundice (Mee et al, 1981).…”

Does this Patient Have Choledocholithiasis?

“…This phenomenon also occurs with unresected ampullary carcinoma. 27 When serum ALP is elevated in the absence of hyperbilirubinaemia, the diagnosis can either be choledocholithiasis 28 or involvement of the liver by a focal space-occupying, or diffusely infiltrative, lesion. 20…”