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Unexplained Elevation of Serum Alkaline Phosphatase Levels-Reply FREE

Peter G. Steinherz, MD; Laurel J. Steinherz, MD
JAMA. 1985;253(18):2646-2646. doi:10.1001/jama.1985.03350420055015
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In Reply.—  The case history described by Dr Dodds and those sent to us directly by other readers of The Journal since publication of the article highlight the need for increased awareness of the entity by clinicians.The question as to the source of the enzyme and the stimulus for its brief hypersecretion is still unresolved. Unfortunately, details are not available in the references cited by Dr Dodds, as these consist of brief anecdotal case reports or collections of few cases. Their own authors state at times that their comments regarding the source of the enzyme and specific patterns are "speculation."1,2 We cannot, therefore, draw definite conclusions about hyperphosphatasemia from the information available and can only confirm that its occurrence is benign.

REFERENCES

Rosalki SB, Foo Y:  Transient hyperphosphatasemia of infancy: Four new cases, and a suggested etiology . Clin Chem 1980;;26:1109-1110.
Rosalki SB, Foo AY:  Origin of anodally migrating alkaline phosphatase isoenzyme in transient hyperphosphatasemia of infancy . Clin Chem 1983;;29:1444.

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Rosalki SB, Foo Y:  Transient hyperphosphatasemia of infancy: Four new cases, and a suggested etiology . Clin Chem 1980;;26:1109-1110.
Rosalki SB, Foo AY:  Origin of anodally migrating alkaline phosphatase isoenzyme in transient hyperphosphatasemia of infancy . Clin Chem 1983;;29:1444.
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