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/* Causes of Decreased Leukocyte Alkaline PhosphataseSailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms...
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==Causes of Decreased Leukocyte Alkaline Phosphatase<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 of Decreased Leukocyte Alkaline Phosphatase
 
===Common Causes===
===Common Causes===
* [[Aplastic anemia]]
* [[Aplastic anemia]]
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* [[Iron deficiency anemia]]
* [[Iron deficiency anemia]]
* [[Paroxysmal nocturnal hemoglobinuria]]
* [[Paroxysmal nocturnal hemoglobinuria]]
* [[Systemic lupus erythematosus]]<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><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 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>
* [[Systemic lupus erythematosus]]<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><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===

Revision as of 20:57, 17 July 2013

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

Common Causes

Causes by Organ System

Cardiovascular 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's disease, diabetes, diabetic coma, diabetic ketoacidosis
Environmental Heatstroke
Gastroenterologic Appendicitis, cholangitis, cholecystitis, gastric carcinoma, fulminant 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 syndrome, leukocyte adhesion factor deficiency, Pelger-Huet anomaly, rac mutation
Hematologic Acute lymphoblastic leukemia, acute myelogenous leukemia, agnogenic myeloid metaplasia, aplastic anemia, chronic neutrophilic leukemia, 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 splenectomy, 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, 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, intracerebral hemorrhage, preeclampsia, 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, 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, intracerebral 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

==Causes of Decreased Leukocyte Alkaline Phosphatase

Common Causes

Causes by Organ System

Cardiovascular Histoplasmosis endocarditis, tricuspid atresia
Chemical/Poisoning Mustard gas
Dental No underlying causes
Dermatologic Atopic dermatitis
Drug Side Effect Acetazolamide, albuterol, dopamine, epinephrine, glucagon, granulocyte colony-stimulating factor, insulin, [salicylate ]], systemic corticosteroids, terbutaline
Ear Nose Throat No underlying causes
Endocrine Addison's disease, calcitonin, diabetes mellitus, hungry bone syndrome, hyperparathyroidism, hyperthyroidism, hypoparathyroidism, hypothyroidism
Environmental No underlying causes
Gastroenterologic Bacterial overgrowth, bariatric surgery , blind loops, carcinoid syndrome, carcinoma of pancreas, celiac disease, chronic pancreatitis, crohn's disease, cystic fibrosis, eosinophilic gastroenteritis, fish tape worm, giardia lamblia, hepatic failure, hookworm, intestinal tuberculosis, lactose intolerance, primary bile acid diarrhea, radiation enteritis, refeeding syndrome, roundworm , short bowel syndrome, sucrose intolerance, traveller's diarrhoea, tropical sprue, Whipple's disease
Genetic Abetalipoproteinemia, beta thalassemia, cystic fibrosis, hereditary hyperphosphatasia, hereditary hypophosphatemia, hereditary hypophosphatemic rickets, hereditary vitamin D-resistant rickets, IgG monoclonal gammopathy, malignant histiocytosis, myeloproliferative variants of hypereosinophilic sundrome, paroxysmal nocturnal hemoglobinuria, primary myelofibrosis, trilineage dysplasia
Hematologic Acute myelogenous leukemia, aplastic anemia, Atypical chronic myeloid leukemia , beta thalassemia , blood transfusion , chronic eosinophilic leukemia, chronic myelogenous leukemia, chronic myelomonocytic leakemia, erythroblastosis fetalis, essential thrombocythemia, fanconi syndrome, hemolysis, idiopathic hypereosinophilic syndrome, idiopathic thrombocytopenic purpura, iron deficiency anemia, myeloproliferative variants of hypereosinophilic sundrome, non hodgkins lymphoma, paroxysmal nocturnal hemoglobinuria, pernicious anemia, primary myelofibrosis, refractory anemia with ringed sideroblasts, refractory thrombocytopenia , sickle cell lung disease, sideroachrestic anemia, sideroblastic anemia, thrombocytopenic purpura
Iatrogenic Bariatric surgery , blood transfusion , gastrectomy, vagotomy
Infectious Disease Fish tape worm, giardia lamblia, histoplasmosis endocarditis, HIV, hookworm, infectious mononucleosis, intestinal tuberculosis, roundworm , traveller's diarrhoea
Musculoskeletal/Orthopedic Degenerative arthritis, hereditary hypophosphatemic rickets, oncogenic osteomalacia, osteo arthritis, osteomalacia
Neurologic Dementia, thoracic ganglioneuroma
Nutritional/Metabolic Acute respiratory alkalosis, bacterial overgrowth, bariatric surgery , blind loops, celiac disease, chronic pancreatitis, chronic renal failure, Crohn's disease, gastrectomy, hereditary vitamin D-resistant rickets, hungry bone syndrome, hypophosphatemia, primary bile acid diarrhea, radiation enteritis, refeeding syndrome, respiratory alkalosis, short bowel syndrome, sucrose intolerance, tropical sprue, Whipple's disease
Obstetric/Gynecologic No underlying causes
Oncologic Acute myelogenous leukemia, atypical chronic myeloid leukemia , carcinoid syndrome, carcinoma of pancreas, chronic eosinophilic leukemia, chronic myelogenous leukemia, chronic myelomonocytic leukemia, malignant diseases, malignant lymphoma, non Hodgkins lymphoma, oncogenic osteomalacia, thoracic ganglioneuroma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric Chronic fatigue, dementia, panic attacks
Pulmonary Acute respiratory alkalosis, cystic fibrosis, respiratory alkalosis, sickle cell lung disease
Renal/Electrolyte Chronic renal failure, post renal transplant
Rheumatology/Immunology/Allergy Blood transfusion , collagen vascular diseases, fibromyalgia, pernicious anemia, post renal transplant, sarcoidosis, systemic lupus erythematosus, systemic sclerosis
Sexual No underlying causes
Trauma Burns
Urologic No underlying causes
Miscellaneous Alcohol, amyloidosis, citrated blood sample, EDTA blood sample, fluoride blood sample, inadequate phosphate intake, old blood samples, oxalate blood sample

Causes in Alphabetical Order

References

  1. ↑ Brook J, Dreisbach PB (1977). "Leukocyte alkaline phosphatase levels in multiple myeloma". J Lab Clin Med. 90 (1): 114–7. PMID 406335.
  2. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  3. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  4. ↑ 4.0 4.1 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)
  5. ↑ 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)
  6. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  7. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  8. ↑ 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. ↑ 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)


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