Clinics and Departments

Laboratory Services

Lab Dept:

Chemistry

Test Name:

ALKALINE PHOSPHATASE ISOENZYMES

General Information

Lab Order Codes:

ALFR

Synonyms:

ALK Isoenzymes, serum; Alkaline Phosphatase Fractionation; ALP Isoenzymes; Regan Isoenzymes

CPT Codes:

84080 – Alkaline phosphatase; isoenzymes
84075 – Alkaline phosphatase; total

Test Includes:

Alkaline phosphatase, total; Alkaline phosphatase, isoenzymes (bone, liver and other fraction) reported in U/L and IU/L.

Logistics

Test Indications:

Useful for determining the tissue source of elevated total alkaline phosphatase activity in serum. Differentiating between a liver and bone source of ALP. Diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases.

Lab Testing Sections:

Chemistry - Sendouts

Referred to:

Mayo Medical Laboratories (MML Test: 89503/ALKI)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily, 24 hours

Turnaround Time:

2 – 4 days, Monday - Friday

Special Instructions:

None

Specimen

Specimen Type:

Blood

Container:

Red top tube

Draw Volume:

3 mL (Minimum: 1.5. mL) blood

Processed Volume:

1 mL (Minimum: 0.5 mL) serum

Collection:

Routine venipuncture

Special Processing:

Lab Staff: Centrifuge specimen, remove serum aliquots and place into TWO screw-capped round bottom plastic vials (Recommended: 0.5 mL into each vial - Minimum: 0.25 mL into each vial). Store and ship at frozen temperatures. Forward promptly.

Patient Preparation:

None

Sample Rejection:

Hemolysis; warm specimens; mislabeled or unlabeled specimens

Interpretive

Reference Range:

Total Alkaline Phosphatase (U/L)

Age:

Male:

Female:

<4 years

Not established

Not established

4 years

149 - 369 U/L

169 - 372 U/L

5 years

179 - 416 U/L

162 - 355 U/L

6 years

179 - 417 U/L

169 - 370 U/L

7 years

172 - 405 U/L

183 - 402 U/L

8 years

169 - 401 U/L

199 - 440 U/L

9 years

175 - 411 U/L

212 - 468 U/L

10 years

191 - 435 U/L

215 - 476 U/L

11 years

185 - 507 U/L

178 - 526 U/L

12 years

185 - 562 U/L

133 - 485 U/L

13 years

182 - 587 U/L

120 - 449 U/L

14 years

166 - 571 U/L

153 - 362 U/L

15 years

138 - 511 U/L

75 - 274 U/L

16 years

102 - 417 U/L

61 - 264 U/L

17 years

69 - 311 U/L

 

18 years

52 - 222 U/L

 

≥19 years

45 - 115 U/L

 

17 - 23 years

 

52 - 144 U/L

24 - 45 years

 

37 - 98 U/L

46 - 50 years

 

39 - 100 U/L

51 - 55 years

 

41 - 108 U/L

56 - 60 years

 

46 - 118 U/L

61 - 65 years

 

50 - 130 U/L

≥66 years

 

55 - 142 U/L

Isoenzymes:

Age

Liver Fraction 1 (%)

Liver Fraction 1 (IU/L)

0 - 6 years

5.1 - 49%

7.0 - 112.7 IU/L

7 - 9 years

3.0 - 45.0%

7.4 - 109.1 IU/L

10 - 13 years

2.9 - 46.3%

7.8 - 87.6 IU/L

14 - 15 years

7.8 - 48.9%

10.3 - 75.6 IU/L

16 - 18 years

14.9 - 50.5%

13.7 - 78.5 IU/L

≥19 years

27.8 - 76.3%

16.2 - 70.2 IU/L

Age

Live Fraction 2 (%)

Liver Fraction 2 (IU/L)

0 - 6 years

2.9 - 13.7%

3.0 - 41.5 IU/L

7 - 9 years

3.7 - 12.5%

4.0 - 35.6 IU/L

10 - 13 years

2.9 - 22.3%

3.3 - 37.8 IU/L

14 - 15 years

2.2 - 19.8%

2.2 - 32.1 IU/L

16 - 18 years

1.9 - 12.5%

1.4 - 19.7 IU/L

≥19 years

0.0 - 8.0%

0.0 - 5.8 IU/L

Age

Bone Fraction (%)

Bone Fraction (IU/L)

0 - 6 years

41.5 - 82.7%

43.5 - 208.1 IU/L

7 - 9 years

39.9 - 85.8%

41.0 - 258.3 IU/L

10 - 13 years

31.8 - 91.1%

39.4 - 346.1 IU/L

14 - 15 years

30.6 - 85.4%

36.4 - 320.5 IU/L

16 - 18 years

38.9 - 72.6%

32.7 - 214.6 IU/L

≥19 years

19.1 - 67.7%

12.1 - 42.7 IU/L

Age

Intestine Fraction (%)

Intestine Fraction (IU/L)

0 - 6 years

0.0 - 18.4 %

0.0 - 37.7 IU/L

7 - 9 years

0.0 - 18.3 %

0.0 - 45.6 IU/L

10 - 13 years

0.0 - 11.8%

0.0 - 40.0 IU/L

14 - 15 years

0.0 - 8.2%

0.0 - 26.4 IU/L

16 - 18 years

0.0 - 8.7%

0.0 - 12.7 IU/L

≥19 years

0.0 - 20.6%

0.0 - 11.0 IU/L

Placental Fraction (all ages)

Not present

Critical Values:

N/A

Limitations:

None

Methodology:

Total Alkaline Phosphatase: Photometric, p-Nitrophenol Phosphatase
Isoenzymes: Electrophoreses

References:

Mayo Medical Laboratories Web Page (April 2011)

Updates:

9/26/2007: Test now forwarded to ARUP laboratories. Previously performed at Mayo Medical Laboratories. Note changes in isoenzymes and reference ranges.
12/7/2008: Test done internally at Mayo. New reference ranges.
4/19/2011: Added comment, no ranges established for <4 year on ALP Total.



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