Leukocyte alkaline phosphatase

Leukocyte alkaline phosphatase

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Vendhan Ramanujam M.B.B.S [2]

Overview

• Alkaline phosphatase is an enyzme present throughout the body
• Alkaline phosphatase functions optimally at pH 8.6
• Leukocyte alkaline phosphatase is a test that tests the level of enzyme within the white blood cells
• Sometimes referred to as LAP

Causes of increased leukocyte alkaline phosphatase

Common causes

• Acute leukemia
• Aplastic Anemia
• Malignant lymphomas
• Megaloblastic anemia
• Multiple Myeloma
• Osteomyelofibrosis
• Polycythemia Vera
• Solid tumors
• Tissue necrosis

Causes by Organ System

Cardiovascular	Atrial fibrillation, Giant cell arteritis, Hemorrhagic shock, Ischemic colitis, Myocardial infarction, Pericarditis, Subacute endocarditis, Vasculitis
Chemical/Poisoning	Camphor, Lead, Lithium, Mercury, Pyrogallol, Snakebite, Turpentine
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	All-trans retinoic acid, Arsphenamine, Catecholamines , Corticosteroids, Dapsone, Digitalis, Neuroleptic malignant syndrome, Oral contraceptives, Phenacetin, Quinidine, Sulfa drugs
Ear Nose Throat	Tonsillitis
Endocrine	Cushing disease, Diabetes, Diabetic coma, Diabetic ketoacidosis
Environmental	Heatstroke
Gastroenterologic	Appendicitis, Cholangitis, Cholecystitis, Gastric carcinoma, Hepatic necrosis, Ischemic colitis, Liver abscess, Liver fluke
Genetic	Congenital Asplenia, Congenital neutropenia , Down syndrome, Familial cold autoinflammatory syndrome, Fanconi anemia, Hereditary neutrophilia, Hyposplenism, Klinefelter syndrome, Kostmann's syndrome, Leukocyte adhesion factor deficiency, Pelger-huet anomaly, Rac mutation
Hematologic	Acute lymphoblastic leukemia, Acute myelogenous leukemia, Agnogenic myeloid metaplasia, Aplastic anemia, Essential thrombocytopenia, Fanconi anemia, Hairy cell leukemia, Hemarthrosis, Hemolysis, Hemoperitoneum, Hemorrhagic shock, Hodgkin's lymphoma, Infectious mononucleosis , Megaloblastic anemia, Multiple myeloma, Myelofibrosis, Pelger-huet anomaly, Polycythemia vera
Iatrogenic	Blood transfusion, G-CSF, GM-CSF, Post spleenectomy , Vaccination
Infectious Disease	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, Perinephric abscess, Pertussis, Plague, Poliomyelitis, Pseudomonas aeruginosa, Pyelonephritis, Rabies, Rheumatic disease, Rickettsia, Salmonella typhi, Salpingitis, Sepsis, Septic arthritis, Smallpox, Spirochetes, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus pyogenes, Subacute endocarditis, Tonsillitis, Varicella, Visceral larva migrans
Musculoskeletal/Orthopedic	Septic arthritis
Neurologic	Eclampsia, Epidural hemorrhage, Intra cerebral hemorrhage, Pre eclampsia, Subdural hemorrhage
Nutritional/Metabolic	Diabetic coma, Diabetic ketoacidosis, Uremia
Obstetric/Gynecologic	Cesarean delivery, Eclampsia, Pelvic inflammatory disease, Preeclampsia, Pregnancy, Salpingitis
Oncologic	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
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	Chronic anxiety state, Depression, Panic disorders, Posttraumatic stress disorder
Pulmonary	Bronchogenic carcinoma , Hemoperitoneum, Klebsiella pneumoniae
Renal/Electrolyte	Perinephric abscess, Pyelonephritis, Renal carcinoma, Renal insufficiency
Rheumatology/Immunology/Allergy	Acute gout, Giant cell arteritis, Rheumatic disease, Rheumatoid arthritis, Vasculitis
Sexual	No underlying causes
Trauma	Burns, Epidural hemorrhage, Hemarthrosis, Hemoperitoneum, Intra cerebral hemorrhage, Major tissue injury, Subdural hemorrhage
Urologic	No underlying causes
Miscellaneous	Chronic idiopathic neutrophilia, Cigarette smoking, Emotional stress, Insect venoms, Physical stress, Vigorous exercise

Causes in Alphabetical Order

• Actinomyces
• Acute gout
• Acute lymphoblastic leukemia
• Acute myelogenous leukemia
• Agnogenic myeloid metaplasia
• All-trans retinoic acid
• Antipyrine
• Aplastic anemia
• Appendicitis
• Arsphenamine
• Atrial fibrillation
• Blood transfusion
• Bronchogenic carcinoma
• Burkholderia mallei
• Burns
• Camphor
• Catecholamines
• Cellulitis
• Cesarean delivery
• Cholangitis
• Cholecystitis
• Chronic anxiety state
• Chronic idiopathic neutrophilia
• Cigarette smoking
• Clostridium difficile
• Coccidioides immitis
• Congenital Asplenia
• Congenital neutropenia
• Corticosteroids
• Cushing disease
• Dapsone
• Depression
• Diabetes
• Diabetic coma
• Diabetic ketoacidosis
• Digitalis
• Diphtheria
• Down syndrome
• Eclampsia
• Emotional stress
• Epidural hemorrhage
• Escherichia coli
• Essential thrombocytopenia
• Familial cold autoinflammatory syndrome
• Fanconi anemia
• G-CSF
• Gastric carcinoma

• Giant cell arteritis
• Glucocortico steroids
• GM-CSF
• Hairy cell leukemia
• Heatstroke
• Hemarthrosis
• Hemolysis
• Hemoperitoneum
• Hemorrhagic shock
• Hepatic necrosis
• Hereditary neutrophilia
• Herpes zoster
• Hodgkin's lymphoma
• Hyposplenism
• Infectious mononucleosis
• Insect venoms
• Intra cerebral hemorrhage
• Ischemic colitis
• Klebsiella pneumoniae
• Klinefelter syndrome
• Kostmann's syndrome
• Lead
• Leukocyte adhesion factor deficiency
• Lithium
• Liver abscess
• Liver fluke
• Major tissue injury
• Malaria
• Megaloblastic anemia
• Mercury
• Multiple myeloma
• Mycobacterium tuberculosis
• Myelofibrosis
• Myocardial infarction
• Neisseria gonorrhoeae
• Neisseria meningitidis
• Neuroleptic malignant syndrome
• Oral contraceptives
• Osteomyelitis
• Otitis media
• Panic disorders
• Paraneoplastic phenomenon
• Pelger-huet anomaly
• Pelvic abscess
• Pelvic inflammatory disease
• Pericarditis
• Perinephric abscess

• Peritonitis
• Pertussis
• Phenacetin
• Physical stress
• Plague
• Poliomyelitis
• Polycythemia vera
• Post spleenectomy
• Posttraumatic stress disorder
• Preeclampsia
• Pregnancy
• Pseudomonas aeruginosa
• Pyelonephritis
• Pyrogallol
• Quinidine
• Rabies
• Rac mutation
• Renal carcinoma
• Renal insufficiency
• Rheumatic disease
• Rheumatoid arthritis
• Rickettsia
• Salmonella typhi
• Salpingitis
• Sepsis
• Septic arthritis
• Smallpox
• Snakebite
• Spirochetes
• Squamous cell carcinoma
• Staphylococcus aureus
• Staphylococcus epidermidis
• Streptococcus pneumoniae
• Streptococcus pyogenes
• Subacute endocarditis
• Subdural hemorrhage
• Sulfa drugs
• Tonsillitis
• Trauma
• Turpentine
• Uremia
• Vaccination
• Varicella
• Vasculitis
• Vigorous exercise
• Visceral larva migrans

Causes of decreased leukocyte alkaline phosphatase

Common causes

• Anemia
• Chronic Myelogenous Leukemia
• Hemolysis
• Iron deficiency anemia
• Sideroachrestic anemia (SA)

Causes by Organ System

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Disease A
• Disease B
• Disease C
• Disease ...

• Disease P
• Disease Q
• Disease R
• Disease ...

• Disease X
• Disease Y
• Disease Z