Table 1.
Differential diagnosis of raised serum alkaline phosphatase concentrations with regard to the origin of isoenzymes
| Tissue non-specific isoenzyme | Placental isoenzyme | Intestinal isoenzyme | |
| Normal tissue origin | Early placenta (<10 weeks) | Term placenta | Intestine |
| Liver | Uterus | ||
| Bone | Testis | ||
| Kidney | |||
| Bone diseases | Fracture | ||
| Paget’s disease | |||
| Rachitis | |||
| Osteomalacia | |||
| D-Hypervitaminosis | |||
| Osteogenesis inperfecta | |||
| Osteoporosis | |||
| Hepatic diseases | Hepatitis | Cholestasis | Cirrhosis |
| Obstructive icterus | Gilbert syndrome | ||
| Primary biliary cirrhosis | |||
| Cholestasis | |||
| Renal disease | Renal failure | Renal failure | |
| Chronic renal disease | |||
| Endocrine diseases | Hyperthyroidism | Diabetes mellitus | |
| Hyperparathyroidism | |||
| Acromegaly | |||
| Cushing’s syndrome | |||
| Malignant tumours | Hepatocellular carcinoma | Ovarian carcinoma | |
| Bone sarcoma | Pancreas carcinoma | ||
| Lymphoma | Gastric carcinoma | ||
| Bone and liver metastasis | |||
| Pregnancy related diseases | IUGR Down’s syndrome | ||
| Pre-eclampsia | |||
| Drug treatment | Antiepileptic treatment | Steroid treatment | |
| Others | Heavy smoking |
IUGR, intrauterine growth restriction.