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Low Alkaline Phosphatase - Hypophosphatasia Is Low Alkaline Phosphatase Of Clinical Importance? ALP enzyme- Discovered in 1923 Low
Phosphatase - Hypophosphatasia ... in 1923 Low ALP ... : Hypophosphatasia ... → ↓ALP • Hypophosphatasia ... #Hyophosphatasia
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
phos/ULN ALP) ... Cholestasis • ALP ... disease • If ALP ... both are normal - ALP ... • Elevation of ALP
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
or AST > ALP): ... • Severe - ALT ... • Moderate - ALT ... Cholestatic Pattern (ALP ... > ALT or AST):
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
kidney, brain ALT ... for the liver ALP ... Transaminase, ALP ... / ULN ALT) / (ALP ... / ULN ALP)
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
specificity to elevated ALP ... • AST/ALT > ALP ... GGT/5-NT: ↑ - ALP ... disease - If ALP ... hemolysis) • ALP
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury Hepatocellular Liver Injury • AST/ALT elevation
Injury • AST/ALT ... elevation > Alk ... phos • ALT more ... • R value = (ALT ... + ULN ALT) / (alkaline
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism AST and ALT: • AST: liver
Chemistry Tests - AST, ALT ... Metabolism AST and ALT ... cytoplasmic (CAST) • ALT ... clearance - AP ... bile canaliculi (ATP-dependent
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Algorithm Severe ALT ... • Pregnancy - AFLP ... HELLP Moderate ALT ... • Others Mild ALT
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm ALP: - Enzymes that catalyze hydrolysis of organic phosphate
Alkaline Phosphatase (ALP ... Diagnosis Algorithm ALP ... - Increased ALP ... Surgical consult ALP ... #Phosphatase #ALP
Acute Fatty Liver of Pregnancy (AFLP) Pathophysiology: • Defect in fetal free fatty acid metabolism products →
of Pregnancy (AFLP ... Findings: • ↑AST/ALT ... , ↑Tbili/Dbili/AP ... iMedEducation #AFLP
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