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Reason for raised ALP, with no liver abnormality
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General Health
Question #19306
63 days ago
169

Reason for raised ALP, with no liver abnormality - #19306

Sonia

Patient has history of hysterectomy and cholecystectomy and previous 2 times drug induced jaundice before these surgeries ,Now All parameters of LFT are normal except ALP which is rising and is now800, CT and MRCP shows liver hemangiomas with irregular liver margins and no blockage to any duct what can be the cause of this countinuous rising

Age: 47
Chronic illnesses: No
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Doctors' responses

Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
63 days ago
5

Hello ,

Most likely causes Non-liver (bone) source – common Vitamin D deficiency, osteomalacia, Paget’s disease, hyperparathyroidism

Early autoimmune cholestatic liver disease Especially Primary Biliary Cholangitis (PBC)

Chronic drug-induced cholestasis (given past history)

hemangiomas do not usually cause high ALP

Key tests needed GGT (normal = bone source; high = liver source) ALP isoenzymes (if available) Vitamin D, calcium, phosphate, PTH AMA, ANA, IgM Fibroscan

Persistent isolated ALP elevation is most often from bone disease or early cholestatic liver disease. Further targeted testing is essential to identify the source.

I trust this helps Thank you

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
61 days ago
5

Hello dear See the reason behind alkaline phosphatase increase is primary biliary cholangitis with auto immune liber destruction Usually in this problem rest findings are normal but Alp increases Iam suggesting some tests Please get them done for confirmation Serum ggt Serum alp repeat Albumin globulin ratio Alt Cck Serum bilirubin Serum ferritin Please share the result with hepatologist in person for better clarity Please donot take any medication without consulting the concerned physician Regards

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Increased alkaline phosphatase (ALP) levels, despite having a normal liver function test and imaging results, can stem from various causes beyond liver issues. While hemangiomas and irregular liver margins noted in imaging are noteworthy, they aren’t typically associated with elevated ALP. Outside the liver, ALP can be elevated due to conditions related to bones, as the enzyme is found in high concentrations in bone tissue. In adults, increased ALP might indicate Paget’s disease of bone, osteomalacia, or bone metastases, although further assessment like a bone scan would be needed to confirm such conditions. It’s also important to consider the patient’s age and any symptoms like bone pain or recent fractures which could support bone-related causes. Hyperparathyroidism could also raise ALP and might warrant checking calcium and parathyroid hormone levels. Since the patient has had surgeries and drug-induced jaundice episodes, a history of medications known to affect bone turnover or interfere with bile handling might provide additional clues. Checking ALP isoenzymes can help differentiate between hepatic and bone sources. Since high ALP can sometimes be seen in inflammatory bowel conditions, if symptoms like diarrhea or weight loss exist, these should be considered. It’s crucial to work with a healthcare professional to determine the exact source and cause, ensuring appropriate and timely management. Because the elevated ALP could signify an underlying serious condition especially with hemangioma and abnormal liver margins present more aggressive or specific investigations should be pursued.

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