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Reason for raised ALP, with no liver abnormality
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General Health
Question #19306
243 days ago
499

Reason for raised ALP, with no liver abnormality

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

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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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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