Leukocyte alkaline phosphatase: Difference between revisions
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== Overview == | == Overview == | ||
Leukocyte alkaline phosphatase is an [[enzyme]] found within [[white blood cells]]. The blood level of leukocyte alkaline phosphatase is measured in order to help in the diagnosis of certain conditions. Higher levels of the enzyme are seen in [[polycythemia vera]], [[essential thrombocytosis]], [[myelofibrosis|primary myelofibrosis]] and [[leukemoid reaction]]. Lower levels are found in [[chronic myelogenous leukemia]], [[aplastic anemia]], [[paroxysmal nocturnal hemoglobinuria]] and [[acute myelogenous leukemia]]. | Leukocyte alkaline phosphatase is an [[enzyme]] found within [[white blood cells]]. The blood level of leukocyte alkaline phosphatase is measured in order to help in the diagnosis of certain conditions. Higher levels of the enzyme are seen in [[polycythemia vera]], [[essential thrombocytosis]], [[myelofibrosis|primary myelofibrosis]] and [[leukemoid reaction]]. Lower levels are found in [[chronic myelogenous leukemia]], [[aplastic anemia]], [[paroxysmal nocturnal hemoglobinuria]] and [[acute myelogenous leukemia]]. | ||
==Causes of Increased Leukocyte | ==Causes of Increased Leukocyte alkaline phosphatase== | ||
===Life Threatening Causes=== | |||
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | |||
*[[Appendicitis]] | |||
*[[Blood transfusion]] | |||
*[[Burns]] | |||
*[[Diabetic coma]] | |||
*[[Diabetic ketoacidosis]] | |||
*[[Eclampsia]] | |||
*[[Epidural hemorrhage]] | |||
*[[Hemorrhagic shock]] | |||
*[[Fulminant hepatic necrosis|Hepatic necrosis]] | |||
*[[Venom|Insect venoms]] | |||
*[[Intracerebral hemorrhage]] | |||
*[[Ischemic colitis]] | |||
*[[Myocardial infarction]] | |||
*[[Osteomyelitis]] | |||
*[[Pelvic abscess]] | |||
===Common Causes=== | ===Common Causes=== | ||
* [[Acute leukemia]] | *[[Acute leukemia]] | ||
*[[Essential thrombocytosis]] | *[[Essential thrombocytosis]] | ||
*[[Leukemoid reaction]] | *[[Leukemoid reaction]] | ||
* [[Malignant lymphoma]] | *[[Malignant lymphoma]] | ||
* [[Megaloblastic anemia]] | *[[Megaloblastic anemia]] | ||
* [[Multiple Myeloma]]<ref name="pmid406335">{{cite journal| author=Brook J, Dreisbach PB| title=Leukocyte alkaline phosphatase levels in multiple myeloma. | journal=J Lab Clin Med | year= 1977 | volume= 90 | issue= 1 | pages= 114-7 | pmid=406335 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=406335 }} </ref> | *[[Multiple Myeloma]]<ref name="pmid406335">{{cite journal| author=Brook J, Dreisbach PB| title=Leukocyte alkaline phosphatase levels in multiple myeloma. | journal=J Lab Clin Med | year= 1977 | volume= 90 | issue= 1 | pages= 114-7 | pmid=406335 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=406335 }} </ref> | ||
* [[Myelofibrosis]] | *[[Myelofibrosis]] | ||
* [[Polycythemia Vera]] | *[[Polycythemia Vera]] | ||
* | *[[Tumor|Solid tumors]] | ||
* | *[[Necrosis|Tissue necrosis]]<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | ||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width: | {|style="width:80%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[ | |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Giant cell arteritis]], [[hemorrhagic shock]], [[ischemic colitis]], [[myocardial infarction]], [[pericarditis]], [[subacute endocarditis]], [[vasculitis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| [[All-trans retinoic acid]], [[arsphenamine]], [[catecholamines ]], [[corticosteroids]], [[dapsone]], [[digitalis]], [[neuroleptic malignant syndrome]], [[oral contraceptives]], [[phenacetin]], [[quinidine]], [[sulfa drugs]] | |bgcolor="Beige"| [[All-trans retinoic acid]], [[arsphenamine]], [[catecholamines]], [[corticosteroids]], [[dapsone]], [[digitalis]], [[neuroleptic malignant syndrome]], [[oral contraceptives]], [[phenacetin]], [[quinidine]], [[sulfa drugs]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Asplenia|Congenital asplenia]], [[neutropenia|congenital neutropenia]], [[Down syndrome]], [[familial cold urticaria|familial cold autoinflammatory syndrome]], [[Fanconi anemia]], [[hereditary neutrophilia]], [[hyposplenism]], [[Klinefelter syndrome]], [[Kostmann syndrome]], [[Leukocyte adhesion deficiency|leukocyte adhesion factor deficiency]], [[Pelger-Huet anomaly]], [[rac|rac mutation]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| [[Blood transfusion]], [[G-CSF]], [[GM-CSF]], [[splenectomy|post | |bgcolor="Beige"| [[Blood transfusion]], [[G-CSF]], [[GM-CSF]], [[splenectomy|post spleenectomy]], [[vaccination ]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"| [[Abscess]], [[actinomyces]], [[burkholderia mallei]], [[cellulitis]], [[cholangitis]], [[cholecystitis]], [[clostridium difficile]], [[coccidioides immitis]], [[escherichia coli]], [[herpes zoster]], [[infectious mononucleosis]], [[klebsiella pneumoniae]], [[liver abscess]], [[liver fluke]], [[malaria]], [[mycobacterium tuberculosis]], [[neisseria gonorrhoeae]], [[osteomyelitis]], [[otitis media]], [[pelvic abscess]], [[pelvic inflammatory disease]], [[pertussis]], [[plague]], [[poliomyelitis]], [[pseudomonas aeruginosa]], [[pyelonephritis]], [[rabies]], [[rickettsia]], [[salmonella typhi]], [[salpingitis]], [[sepsis]], [[septic arthritis]], [[smallpox]], [[spirochetes]], [[staphylococcus aureus]], [[staphylococcus epidermidis]], [[streptococcus pneumoniae]], [[streptococcus pyogenes]], [[subacute endocarditis]], [[tonsillitis]], [[varicella]], [[visceral larva migrans ]] | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal/Orthopedic''' | | '''Musculoskeletal/Orthopedic''' | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| [[Acute lymphoblastic leukemia]], [[acute myelogenous leukemia]], [[agnogenic myeloid metaplasia]], [[bronchogenic carcinoma ]], [[gastric carcinoma]], [[hairy cell leukemia]], [[Hodgkin's lymphoma]], [[paraneoplastic phenomenon]], [[renal carcinoma]], [[squamous cell carcinoma]] | |bgcolor="Beige"| [[Acute lymphoblastic leukemia]], [[acute myelogenous leukemia]], [[agnogenic myeloid metaplasia]], [[bronchogenic carcinoma]], [[gastric carcinoma]], [[hairy cell leukemia]], [[Hodgkin's lymphoma]], [[paraneoplastic phenomenon]], [[renal carcinoma]], [[squamous cell carcinoma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Psychiatric''' | | '''Psychiatric''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Anxiety|Chronic anxiety]], [[depression]], [[panic disorders]], [[posttraumatic stress disorder]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| [[Bronchogenic carcinoma]], [[hemoperitoneum]], [[klebsiella pneumoniae ]] | |bgcolor="Beige"| [[Bronchogenic carcinoma]], [[hemoperitoneum]], [[klebsiella pneumoniae]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Abscess]], [[pyelonephritis]], [[renal carcinoma]], [[renal insufficiency]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| [[Burns]], [[epidural hemorrhage]], [[hemarthrosis]], [[hemoperitoneum]], [[intracerebral hemorrhage]], | |bgcolor="Beige"| [[Burns]], [[epidural hemorrhage]], [[hemarthrosis]], [[hemoperitoneum]], [[intracerebral hemorrhage]], [[tissue|major tissue injury]], [[subdural hemorrhage]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| Chronic idiopathic | |bgcolor="Beige"| [[neutrophilia|Chronic idiopathic neutrophilia]], [[cigarette smoking]], [[emotional stress]], [[Venom|insect venoms]], [[Stress|physical stress]], [[Exercise|vigorous exercise]] | ||
|- | |- | ||
|} | |} | ||
===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{col-begin|width= | {{col-begin|width=80%}} | ||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[Abscess]] | |||
*[[Actinomyces]] | *[[Actinomyces]] | ||
*[[Gout|Acute gout]] | *[[Gout|Acute gout]] | ||
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*[[Appendicitis]] | *[[Appendicitis]] | ||
*[[Arsphenamine]] | *[[Arsphenamine]] | ||
*[[Blood transfusion]] | *[[Blood transfusion]] | ||
*[[Bronchogenic carcinoma ]] | *[[Bronchogenic carcinoma]] | ||
*[[Burkholderia mallei ]] | *[[Burkholderia mallei]] | ||
*[[Burns]] | *[[Burns]] | ||
*[[Camphor]] | *[[Camphor]] | ||
*[[Catecholamines ]] | *[[Catecholamines]] | ||
*[[Cellulitis]] | *[[Cellulitis]] | ||
*[[Cesarean delivery]] | *[[Cesarean delivery]] | ||
*[[Cholangitis]] | *[[Cholangitis]] | ||
*[[Cholecystitis]] | *[[Cholecystitis]] | ||
* | *[[Anxiety|Chronic anxiety]] | ||
*Chronic idiopathic | *[[Neutrophilia|Chronic idiopathic neutrophilia]] | ||
*[[Chronic neutrophilic leukemia]] | *[[Chronic neutrophilic leukemia]] | ||
*[[Cigarette smoking]] | *[[Cigarette smoking]] | ||
*[[Clostridium difficile]] | *[[Clostridium difficile]] | ||
*[[Coccidioides immitis]] | *[[Coccidioides immitis]] | ||
* | *[[Asplenia|Congenital asplenia]] | ||
* | *[[Neutropenia|Congenital neutropenia]] | ||
*[[Corticosteroids]] | *[[Corticosteroids]] | ||
*[[Cushing's disease]] | *[[Cushing's disease]] | ||
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*[[Escherichia coli]] | *[[Escherichia coli]] | ||
*[[Essential thrombocytopenia]] | *[[Essential thrombocytopenia]] | ||
*Familial cold autoinflammatory syndrome | *[[Familial cold urticaria|Familial cold autoinflammatory syndrome]] | ||
*[[Fanconi anemia]] | *[[Fanconi anemia]] | ||
*[[G-CSF]] | *[[G-CSF]] | ||
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*[[Hodgkin's lymphoma]] | *[[Hodgkin's lymphoma]] | ||
*[[Hyposplenism]] | *[[Hyposplenism]] | ||
*[[Infectious mononucleosis ]] | *[[Infectious mononucleosis]] | ||
*Insect venoms | *[[Venom|Insect venoms]] | ||
*[[Intracerebral hemorrhage]] | *[[Intracerebral hemorrhage]] | ||
*[[Ischemic colitis]] | *[[Ischemic colitis]] | ||
*[[Klebsiella pneumoniae ]] | *[[Klebsiella pneumoniae]] | ||
*[[Klinefelter syndrome]] | *[[Klinefelter syndrome]] | ||
*[[Kostmann syndrome]] | *[[Kostmann syndrome]] | ||
*[[Lead]] | *[[Lead]] | ||
*Leukocyte adhesion factor deficiency | *[[Leukocyte adhesion deficiency|Leukocyte adhesion factor deficiency]] | ||
*[[Lithium]] | *[[Lithium]] | ||
*[[Liver abscess]] | *[[Liver abscess]] | ||
*[[Liver fluke]] | *[[Liver fluke]] | ||
* | *[[Tissue|Major tissue injury]] | ||
*[[Malaria]] | *[[Malaria]] | ||
*[[Megaloblastic anemia]] | *[[Megaloblastic anemia]] | ||
*[[Mercury]] | *[[Mercury]] | ||
*[[Multiple myeloma]] | *[[Multiple myeloma]] | ||
*[[Mycobacterium tuberculosis ]] | *[[Mycobacterium tuberculosis]] | ||
*[[Myelofibrosis]] | *[[Myelofibrosis]] | ||
*[[Myocardial infarction]] | *[[Myocardial infarction]] | ||
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*[[Otitis media]] | *[[Otitis media]] | ||
*[[Panic disorders]] | *[[Panic disorders]] | ||
*[[Paraneoplastic phenomenon ]] | *[[Paraneoplastic phenomenon]] | ||
*[[Pelger-Huet anomaly]] | *[[Pelger-Huet anomaly]] | ||
*[[Pelvic abscess]] | *[[Pelvic abscess]] | ||
*[[Pelvic inflammatory disease]] | *[[Pelvic inflammatory disease]] | ||
*[[Pericarditis]] | *[[Pericarditis]] | ||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[Peritonitis]] | *[[Peritonitis]] | ||
*[[Pertussis]] | *[[Pertussis]] | ||
*[[Phenacetin]] | *[[Phenacetin]] | ||
* | *[[Stress|Physical stress]] | ||
*[[Plague]] | *[[Plague]] | ||
*[[Poliomyelitis]] | *[[Poliomyelitis]] | ||
*[[Polycythemia vera]] | *[[Polycythemia vera]] | ||
*[[Splenectomy|Post splenectomy ]] | *[[Splenectomy|Post splenectomy]] | ||
*[[Posttraumatic stress disorder]] | *[[Posttraumatic stress disorder]] | ||
*[[Preeclampsia]] | *[[Preeclampsia]] | ||
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*[[Varicella]] | *[[Varicella]] | ||
*[[Vasculitis]] | *[[Vasculitis]] | ||
* | *[[Exercise|Vigorous exercise]] | ||
*[[Visceral larva migrans]] | *[[Visceral larva migrans]] | ||
{{col-end}} | {{col-end}} | ||
==Causes of Decreased Leukocyte Alkaline Phosphatase | ==Causes of Decreased Leukocyte Alkaline Phosphatase== | ||
===Life Threatening Causes=== | |||
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | |||
*[[Burns]] | |||
*[[Epinephrine]] | |||
*[[Respiratory alkalosis]] | |||
*[[Salicylate|Salicylate toxicity]] | |||
*[[Terbutaline|Terbutaline toxicity]] | |||
===Common Causes=== | ===Common Causes=== | ||
* [[ | * [[Aplastic anemia]] | ||
* [[Chronic | * [[Chronic myelogenous leukemia]] | ||
* [[ | * [[Hypophosphatemia]]<ref name="Gaasbeek-2005">{{Cite journal | last1 = Gaasbeek | first1 = A. | last2 = Meinders | first2 = AE. | title = Hypophosphatemia: an update on its etiology and treatment. | journal = Am J Med | volume = 118 | issue = 10 | pages = 1094-101 | month = Oct | year = 2005 | doi = 10.1016/j.amjmed.2005.02.014 | PMID = 16194637 }}</ref> | ||
* [[Iron deficiency anemia]] | * [[Iron deficiency anemia]] | ||
* [[ | * [[Paroxysmal nocturnal hemoglobinuria]] | ||
* [[Systemic lupus erythematosus]]<ref name="TANAKA-1960">{{Cite journal | last1 = TANAKA | first1 = KR. | last2 = VALENTINE | first2 = WN. | last3 = FREDRICKS | first3 = RE. | title = Diseases or clinical conditions associated with low leukocyte alkaline phosphatase. | journal = N Engl J Med | volume = 262 | issue = | pages = 912-8 | month = May | year = 1960 | doi = 10.1056/NEJM196005052621804 | PMID = 13836802 }}</ref><ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref><ref name="Sharma-1980">{{Cite journal | last1 = Sharma | first1 = SC. | title = Leucocyte alkaline phosphatase in neonatal infections. | journal = Postgrad Med J | volume = 56 | issue = 657 | pages = 485-7 | month = Jul | year = 1980 | doi = | PMID = 7443603 }}</ref><ref name="Lokich-1977">{{Cite journal | last1 = Lokich | first1 = JJ. | title = Leukocyte alkaline phosphatase activity in patients with malignant disease. | journal = Cancer | volume = 40 | issue = 3 | pages = 1202-5 | month = Sep | year = 1977 | doi = | PMID = 902237 }}</ref> | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width: | {|style="width:80%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | | |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Histoplasmosis | Histoplasmosis endocarditis]], [[tricuspid atresia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Chemical/Poisoning''' | | '''Chemical/Poisoning''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Mustard gas]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Atopic dermatitis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Acetazolamide]], [[albuterol]], [[dopamine]], [[epinephrine]], [[glucagon]], [[granulocyte colony-stimulating factor]], [[insulin]], [[salicylate]], [[corticosteroids|systemic corticosteroids]], [[terbutaline]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Addison's disease]], [[calcitonin]], [[diabetes mellitus]], [[Parathyroidectomy|hungry bone syndrome]], [[hyperparathyroidism]], [[hyperthyroidism]], [[hypoparathyroidism]], [[hypothyroidism]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Bacterial overgrowth]], [[bariatric surgery]], [[blind loop syndrome]], [[carcinoid syndrome]], [[carcinoma of pancreas]], [[celiac disease]], [[chronic pancreatitis]], [[Crohn's disease]], [[cystic fibrosis]], [[eosinophilic gastroenteritis]], [[Diphyllobothrium | fish tapeworm]], [[giardia lamblia]], [[hepatic failure]], [[hookworm]], [[Tuberculosis | intestinal tuberculosis]], [[lactose intolerance]], [[Bile acid malabsorption|primary bile acid diarrhea]], [[radiation enteritis]], [[refeeding syndrome]], [[roundworm]], [[short bowel syndrome]], [[sucrose intolerance]], [[traveler's diarrhea]], [[tropical sprue]], [[Whipple's disease]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Abetalipoproteinemia]], [[beta thalassemia]], [[cystic fibrosis]], [[hyperphosphatasia|hereditary hyperphosphatasia]], [[X-linked_hypophosphatemia | hereditary hypophosphatemia]], [[Autosomal dominant hypophosphatemic rickets | hereditary hypophosphatemic rickets]], [[Vitamin D resistant rickets|hereditary vitamin D-resistant rickets]], [[Monoclonal gammopathy of undetermined significance | IgG monoclonal gammopathy]], [[malignant histiocytosis]], [[hypereosinophilic syndrome|myeloproliferative variants of hypereosinophilic syndrome]], [[paroxysmal nocturnal hemoglobinuria]], [[Myelofibrosis | primary myelofibrosis]], [[dysplasia|trilineage dysplasia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Acute myelogenous leukemia]], [[aplastic anemia]], [[Chronic myelogenous leukemia |atypical chronic myeloid leukemia]], [[beta thalassemia]], [[blood transfusion]], [[chronic eosinophilic leukemia]], [[chronic myelogenous leukemia]], [[chronic myelomonocytic leukemia]], [[erythroblastosis fetalis]], [[essential thrombocythemia]], [[fanconi syndrome]], [[hemolysis]], [[idiopathic hypereosinophilic syndrome]], [[idiopathic thrombocytopenic purpura]], [[iron deficiency anemia]], [[hypereosinophilic syndrome|myeloproliferative variants of hypereosinophilic syndrome]], [[non-Hodgkin lymphoma]], [[paroxysmal nocturnal hemoglobinuria]], [[pernicious anemia]], [[Myelofibrosis | primary myelofibrosis]], [[Thrombocytopenia | refractory thrombocytopenia]], [[sickle cell disease]], [[sideroachrestic anemia]], [[sideroblastic anemia]], [[thrombocytopenic purpura]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Bariatric surgery]], [[blood transfusion]], [[gastrectomy]], [[vagotomy]] | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Diphyllobothrium |fish tapeworm]], [[giardia lamblia]], [[Histoplasmosis |histoplasmosis endocarditis]], [[HIV]], [[hookworm]], [[infectious mononucleosis]], [[Tuberculosis | intestinal tuberculosis]], [[roundworm]], [[traveler's diarrhea]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal/Orthopedic''' | | '''Musculoskeletal/Orthopedic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Osteoarthritis | degenerative arthritis]], [[Autosomal dominant hypophosphatemic rickets |hereditary hypophosphatemic rickets]], [[oncogenic osteomalacia]], [[osteoarthritis]], [[osteomalacia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Dementia]], [[ganglioneuroma |thoracic ganglioneuroma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Bacterial overgrowth]], [[bariatric surgery]], [[blind loop syndrome]], [[celiac disease]], [[chronic pancreatitis]], [[chronic renal failure]], [[Crohn's disease]], [[gastrectomy]], [[X-linked_hypophosphatemia |hereditary hypophosphatemia]], [[vitamin D resistant rickets|hereditary vitamin D-resistant rickets]], [[Parathyroidectomy|hungry bone syndrome]], [[hypophosphatemia]], [[Bile acid malabsorption|primary bile acid diarrhea]], [[radiation enteritis]], [[refeeding syndrome]], [[respiratory alkalosis]], [[short bowel syndrome]], [[sucrose intolerance]], [[tropical sprue]], [[Whipple's disease]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Acute myelogenous leukemia]], [[Chronic myelogenous leukemia |atypical chronic myelogenous leukemia]], [[carcinoid syndrome]], [[carcinoma of pancreas]], [[chronic eosinophilic leukemia]], [[chronic myelogenous leukemia]], [[chronic myelomonocytic leukemia]], [[malignant diseases]], [[malignant lymphoma]], [[non-Hodgkin lymphoma]], [[oncogenic osteomalacia]], [[ganglioneuroma|thoracic ganglioneuroma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Psychiatric''' | | '''Psychiatric''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Chronic fatigue syndrome]], [[dementia]], [[panic attacks]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Cystic fibrosis]], [[Respiratory alkalosis |respiratory alkalosis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Chronic renal failure]], [[renal transplant]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Blood transfusion]], [[collagen vascular diseases]], [[fibromyalgia]], [[pernicious anemia]], [[renal transplant]], [[sarcoidosis]], [[systemic lupus erythematosus]], [[systemic sclerosis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Burns]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Alcohol]], [[amyloidosis]], [[citrate|citrated blood sample]], [[EDTA |EDTA blood sample]], [[fluoride|fluoride treated blood sample]], [[phosphate|inadequate phosphate intake]], [[blood|old blood samples]], [[oxalate|oxalate blood sample]] | ||
|- | |- | ||
|} | |} | ||
===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== | ||
{{col-begin|width= | {{col-begin|width=80%}} | ||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[ | *[[Abetalipoproteinemia]] | ||
*[[ | *[[Acetazolamide]] | ||
*[[ | *[[Acquired hemolytic anemia]] | ||
*[[ | *[[Acute myelogenous leukemia]] | ||
*[[Addison's disease]] | |||
*[[Albuterol]] | |||
*[[Alcohol]] | |||
*[[Amyloidosis]] | |||
*[[Aplastic anemia]] | |||
*[[Atherosclerotic heart disease]] | |||
*[[Atopic dermatitis]] | |||
*[[Chronic myelogenous leukemia |Atypical chronic myelogenous leukemia]] | |||
*[[Bacterial overgrowth]] | |||
*[[Bariatric surgery]] | |||
*[[Beta thalassemia]] | |||
*[[Blind loop syndrome]] | |||
*[[Blood transfusion]] | |||
*[[Burns]] | |||
*[[Calcitonin]] | |||
*[[Carcinoid syndrome]] | |||
*[[Carcinoma of pancreas]] | |||
*[[Celiac disease]] | |||
*[[Chronic eosinophilic leukemia]] | |||
*[[Chronic fatigue syndrome]] | |||
*[[Chronic myelogenous leukemia]] | |||
*[[Chronic myelomonocytic leukemia]] | |||
*[[Chronic pancreatitis]] | |||
*[[Chronic renal failure]] | |||
*[[Citrate|Citrated blood sample]] | |||
*[[Collagen vascular diseases]] | |||
*[[Crohn's disease]] | |||
*[[Cystic fibrosis]] | |||
*[[Osteoarthritis | Degenerative arthritis]] | |||
*[[Dementia]] | |||
*[[Diabetes mellitus]] | |||
*[[Dopamine]] | |||
*[[EDTA | EDTA blood sample]] | |||
*[[Eosinophilic gastroenteritis]] | |||
*[[Epinephrine]] | |||
*[[Erythroblastosis fetalis]] | |||
*[[Essential thrombocythemia]] | |||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[ | *[[Fanconi syndrome]] | ||
*[[ | *[[Fibromyalgia]] | ||
*[[ | *[[Diphyllobothrium |Fish tapeworm]] | ||
*[[ | *[[Fluoride|Fluoride treated blood sample]] | ||
*[[Gastrectomy]] | |||
*[[Giardia lamblia]] | |||
*[[Glucagon]] | |||
*[[Granulocyte colony-stimulating factor]] | |||
*[[Hepatic failure]] | |||
*[[Hyperphosphatemia|Hereditary hyperphosphatasia]] | |||
*[[X-linked_hypophosphatemia|Hereditary hypophosphatemia]] | |||
*[[Autosomal dominant hypophosphatemic rickets|Hereditary hypophosphatemic rickets]] | |||
*[[Vitamin D resistant rickets|Hereditary vitamin D-resistant rickets]] | |||
*[[Histoplasmosis|Histoplasmosis endocarditis]] | |||
*[[HIV]] | |||
*[[Hookworm]] | |||
*[[Parathyroidectomy|Hungry bone syndrome]] | |||
*[[Hyperparathyroidism]] | |||
*[[Hypertension]] | |||
*[[Hyperthyroidism]] | |||
*[[Hypoparathyroidism]] | |||
*[[Hypophosphatemia]] | |||
*[[Hypothyroidism]] | |||
*[[Idiopathic hypereosinophilic syndrome]] | |||
*[[Idiopathic thrombocytopenic purpura]] | |||
*[[Monoclonal gammopathy of undetermined significance | IgG monoclonal gammopathy]] | |||
*[[Phosphate|Inadequate phosphate intake]] | |||
*[[Infectious mononucleosis]] | |||
*[[Insulin]] | |||
*[[Tuberculosis | Intestinal tuberculosis]] | |||
*[[Iron deficiency anemia]] | |||
*[[Lactose intolerance]] | |||
*[[Lead]] | |||
*[[Malignant diseases]]<ref name="Lokich-1977">{{Cite journal | last1 = Lokich | first1 = JJ. | title = Leukocyte alkaline phosphatase activity in patients with malignant disease. | journal = Cancer | volume = 40 | issue = 3 | pages = 1202-5 | month = Sep | year = 1977 | doi = | PMID = 902237 }}</ref> | |||
*[[Malignant histiocytosis]] | |||
*[[Malignant lymphoma]] | |||
*[[Mustard gas]] | |||
*[[Myeloid metaplasia]] | |||
*[[Hypereosinophilic syndrome|Myeloproliferative variants of hypereosinophilic syndrome]] | |||
*[[Infection|Neonatal infection]]<ref name="Sharma-1980">{{Cite journal | last1 = Sharma | first1 = SC. | title = Leucocyte alkaline phosphatase in neonatal infections. | journal = Postgrad Med J | volume = 56 | issue = 657 | pages = 485-7 | month = Jul | year = 1980 | doi = | PMID = 7443603 }}</ref> | |||
*[[Niacin]] | |||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[ | *[[Non-Hodgkin lymphoma]] | ||
*[[ | *[[Blood|Old blood samples]] | ||
*[[ | *[[Oncogenic osteomalacia]] | ||
*[[Osteoarthritis]] | |||
*[[Osteomalacia]] | |||
*[[Oxalate|Oxalate treated blood sample]] | |||
*[[Paget's disease]] | |||
*[[Panic attacks]] | |||
*[[Paroxysmal nocturnal hemoglobinuria]] | |||
*[[Pernicious anemia]] | |||
*[[Bile acid malabsorption|Primary bile acid diarrhea]] | |||
*[[Myelofibrosis | Primary myelofibrosis]] | |||
*[[Radiation enteritis]] | |||
*[[Neutropenia|Recurrent neutropenia]] | |||
*[[Refeeding syndrome]] | |||
*[[Thrombocytopenia | Refractory thrombocytopenia]] | |||
*[[Respiratory alkalosis]] | |||
*[[Renal transplant]] | |||
*[[Rheumatoid arthritis]] | |||
*[[Roundworm]] | |||
*[[Salicylate]] | |||
*[[Sarcoidosis]] | |||
*[[Short bowel syndrome]] | |||
*[[Sickle cell disease]] | |||
*[[Sideroachrestic anemia]] | |||
*[[Sideroblastic anemia]] | |||
*[[Myeloid leukemia|Subacute myeloid leukemia]] | |||
*[[Sucrose intolerance]] | |||
*[[Corticosteroids| Systemic corticosteroids]] | |||
*[[Systemic lupus erythematosus]] | |||
*[[Systemic sclerosis]] | |||
*[[Terbutaline]] | |||
*[[ganglioneuroma| Thoracic ganglioneuroma]] | |||
*[[Thrombocytopenic purpura]] | |||
*[[Traveller's diarrhoea]] | |||
*[[Tricuspid atresia]] | |||
*[[Dysplasia|Trilineage dysplasia]] | |||
*[[Tropical sprue]] | |||
*[[Uremia]] | |||
*[[Vagotomy]] | |||
*[[Whipple's disease]] | |||
{{col-end}} | {{col-end}} | ||
== References == | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Crowdiagnosis]] | |||
[[Category:Blood tests]] | |||
[[Category:Up-To-Date]] | |||
{{ | {{WH}} | ||
{{ | {{WS}} | ||
Latest revision as of 14:35, 20 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]
Synonyms and keywords: LAP
Overview
Leukocyte alkaline phosphatase is an enzyme found within white blood cells. The blood level of leukocyte alkaline phosphatase is measured in order to help in the diagnosis of certain conditions. Higher levels of the enzyme are seen in polycythemia vera, essential thrombocytosis, primary myelofibrosis and leukemoid reaction. Lower levels are found in chronic myelogenous leukemia, aplastic anemia, paroxysmal nocturnal hemoglobinuria and acute myelogenous leukemia.
Causes of Increased Leukocyte alkaline phosphatase
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Appendicitis
- Blood transfusion
- Burns
- Diabetic coma
- Diabetic ketoacidosis
- Eclampsia
- Epidural hemorrhage
- Hemorrhagic shock
- Hepatic necrosis
- Insect venoms
- Intracerebral hemorrhage
- Ischemic colitis
- Myocardial infarction
- Osteomyelitis
- Pelvic abscess
Common Causes
- Acute leukemia
- Essential thrombocytosis
- Leukemoid reaction
- Malignant lymphoma
- Megaloblastic anemia
- Multiple Myeloma[1]
- Myelofibrosis
- Polycythemia Vera
- Solid tumors
- Tissue necrosis[2][3]
Causes by Organ System
Causes in Alphabetical Order
Causes of Decreased Leukocyte Alkaline Phosphatase
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Aplastic anemia
- Chronic myelogenous leukemia
- Hypophosphatemia[4]
- Iron deficiency anemia
- Paroxysmal nocturnal hemoglobinuria
- Systemic lupus erythematosus[5][6][7][8][9]
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ Brook J, Dreisbach PB (1977). "Leukocyte alkaline phosphatase levels in multiple myeloma". J Lab Clin Med. 90 (1): 114–7. PMID 406335.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
- ↑ Gaasbeek, A.; Meinders, AE. (2005). "Hypophosphatemia: an update on its etiology and treatment". Am J Med. 118 (10): 1094–101. doi:10.1016/j.amjmed.2005.02.014. PMID 16194637. Unknown parameter
|month=
ignored (help) - ↑ TANAKA, KR.; VALENTINE, WN.; FREDRICKS, RE. (1960). "Diseases or clinical conditions associated with low leukocyte alkaline phosphatase". N Engl J Med. 262: 912–8. doi:10.1056/NEJM196005052621804. PMID 13836802. Unknown parameter
|month=
ignored (help) - ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
- ↑ 8.0 8.1 Sharma, SC. (1980). "Leucocyte alkaline phosphatase in neonatal infections". Postgrad Med J. 56 (657): 485–7. PMID 7443603. Unknown parameter
|month=
ignored (help) - ↑ 9.0 9.1 Lokich, JJ. (1977). "Leukocyte alkaline phosphatase activity in patients with malignant disease". Cancer. 40 (3): 1202–5. PMID 902237. Unknown parameter
|month=
ignored (help)