Adult patient:
Heparin gel tube
Minimum blood volume: 5 mL
Spot fluid:
Plain bottle
Minimum volume: 10 mL
Paediatric heparin tube
Number of vials: 1
Minimum blood volume: 1.3 mL
Authorisation code required
No
No
24 Hr available service
Yes
(Call extension: 3353 for express result)
No
Method
Spectrophotometry
Reference interval
| Male | Low | High | Female | Low | High | Unit | Source |
| Age 0 - 5 | 130 | 380 | Age 0 - 5 | 130 | 330 | U/L | Clin Chem 1983 |
| Age 6 - 12 | 160 | 478 | Age 6 - 9 | 134 | 389 | U/L | Local population study in 2008 |
| Age 13 - 16 | 81 | 447 | Age 10 - 13 | 77 | 388 | U/L | |
| Age 17 - 18 | 43 | 207 | Age 14 - 18 | 45 | 173 | U/L | |
| Age > 19 | 43 | 105 | Age 19 - 50 | 33 | 84 | U/L | |
| Age 51 - 55 | 30 | 90 | U/L | Clin Chem 1983 | |||
| Age > 55 | 45 | 145 | U/L |
(Source:
1. From local population study in 2008
2. Francoise Schiele, Joseph Hanny, Joelle Hitz et al. Total Bone and Liver Alkaline Phosphatases in plasma: Biological Variations and Reference Limits. Clin Chem 1983; 29: 634 - 41)
Female during pregnancy:
| 13 - 20 weeks | 40 - 92 U/L |
| 21 - 28 weeks | 44 - 119 U/L |
| 29 - 34 weeks | 56 - 159 U/L |
| 35 - 42 weeks | 88 - 269 U/L |
| During active labour | 109 - 368 U/L |
| Day 1 postpartum | 96 - 280 U/L |
| 89 - 257 U/L |
(Source: Klajnbard A et al. Laboratory Reference Intervals during Pregnancy, Delivery and the Early Postpartum Period. Clin Chem Lab Med. 2010 Feb; 48(2): 237 - 48.)
Clinical indication
Investigation of hepatobiliary or bone disease
Result interpretation
Increased levels in liver disease (particularly in association with cholestasis), bone disease (with increased osteoblastic activity, e.g. Paget’s disease), some bony metastases (especially prostate and breast), and at times in malignancy without liver or bone metastases (Regan isoenzyme)
May also be elevated in some gastrointestinal diseases or due to a macroenzyme.
Alkaline phosphatase isoenzymes (bone-specific alkaline phosphatase) are rarely necessary to identify the source of an elevated ALP.
Marked but transient elevation of ALP may be seen in children, probably attributable to viral infection.
Abnormal dentition and fragile bones with decreased ALP characterise the autosomal recessive disease hypophosphatasia.
EDTA when present chelates Ca2+ and Mg2+ and thus inactivates the ALP activity.
Measurement of uncertainty
Frequency of measurement
Daily