Skip Ribbon Commands
Skip to main content
Sign In
Navigate Up

26646 Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKP)

Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKP)
Test Code: ALKPSO
Synonyms/Keywords

​Alkaline Phosphatase, Tot and Iso,S

Useful For

​Aid in the diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases​

Determining the tissue source of increased alkaline phosphatase (ALP) activity in serum

Differentiating between liver and bone sources of elevated ALP

Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)
8 hours​
​Serum
​Serum Separator Tube (SST)
​Red Top Tube (RTT)
​1 mL
​1 mL
​
Collection Processing Instructions

​Patient's age and sex are required.

Within 2 hours of collection, centrifuge the specimen.

For red top tubes, immediately aliquot into a plastic vial.

For serum gel tubes, serum may sit on gel refrigerated but must be aliquoted within 7 days.

Specimen Stability Information
Specimen TypeTemperatureTime​
​Serum
​​

​
​
​Ambient
​7 days
​Refrigerated
​7 days
​Frozen (preferred)
​14 days
Rejection Criteria

Gross hemolysis, Gross icterus

Interference

​Alkaline phosphatase (ALP) Isoenzyme:
-High concentrations of phosphate, oxalate, citrate, and cyanide will inhibit ALP activity.
-Excess glycine may inhibit ALP activity by complexing magnesium.
-Patients should be fasting. Patients may have an elevated intestinal ALP about two hours after a fatty meal.

Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Mayo Clinic Laboratories
​Tuesday through Saturday
​​3-5 days
​ALP: Colorimetric
ALPI: Electrophoresis
Reference Lab
Mayo Clinic Laboratories
Test Information

​Serum alkaline phosphatase (ALP) is used in the diagnosis of hepatobiliary disease and bone disease associated with increased osteoblastic activity. ALP is present in a number of tissues including liver, bone, intestine, and placenta. The activity of ALP found in serum is a composite of isoenzymes from those sites.​

A rise in liver ALP activity occurs with all forms of cholestasis, particularly with obstructive jaundice.

Bone ALP is elevated in disorders of the skeletal system that involve osteoblast hyperactivity and bone remodeling, such as Paget disease, rickets, osteomalacia, fractures, and malignant tumors.

Moderate elevation of ALP may be seen in other disorders such as Hodgkin disease, congestive heart failure, ulcerative colitis, regional enteritis, and intra-abdominal bacterial infections.

Reference Range Information
Performing LocationReference Range
​Mayo Clinc Laboratories
​

ALKALINE PHOSPHATASE

Males

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 116-468 U/L

15-<17 years: 82-331 U/L

17-<19 years: 55-149 U/L

> or =19 years: 40-129 U/L

Females

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 57-254 U/L

15-<17 years: 50-117 U/L

> or =17 years: 35-104 U/L

 

ALKALINE PHOSPHATASE ISOENZYMES

Ages:

< or =17 years: Refence values have not been established for patients less than 18 years of age.

> or =18 years:

Liver %: 30.2-74.7

Liver U/L: 15.8-71.9

Bone %: 23.8-68.3

Bone U/L: 12.0-56.7

Intestine %: < or =22.5

Intestine U/L: < or =12.6

Interpretation

​​Liver alkaline phosphatase (ALP) isoenzyme is most frequently elevated when total ALP is elevated. Increased liver ALP is associated with a wide group of conditions including acute hepatitis, cirrhosis, fatty liver, drug induced liver disease, obstruction of biliary flow, bile duct stricture, primary biliary cirrhosis, and metastatic carcinoma of the liver.​

Bone ALP is elevated due to increased osteoblastic activity. Abnormally elevated bone ALP may be indicative of bone tumors, Paget's disease, or renal rickets.

Intestinal ALP is detectable in approximately 20% of samples tested. Intestinal ALP is most frequently noted postprandially in patients with blood group O or B.

Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments
84075​
​​1
​
​84080
​​1
​​
Synonyms/Keywords

​Alkaline Phosphatase, Tot and Iso,S

Ordering Applications
Ordering ApplicationDescription
Cerner​
​Alkaline Phosphatase, Total and Isoenzymes, Serum (ALKP)​
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting RequiredSpecimen TypePreferred Container/TubeAcceptable Container/TubeSpecimen VolumeSpecimen Minimum Volume
(allows for 1 repeat)		Pediatric Minimum Volume
(no repeat)
8 hours​
​Serum
​Serum Separator Tube (SST)
​Red Top Tube (RTT)
​1 mL
​1 mL
​
Collection Processing

​Patient's age and sex are required.

Within 2 hours of collection, centrifuge the specimen.

For red top tubes, immediately aliquot into a plastic vial.

For serum gel tubes, serum may sit on gel refrigerated but must be aliquoted within 7 days.

Specimen Stability Information
Specimen TypeTemperatureTime​
​Serum
​​

​
​
​Ambient
​7 days
​Refrigerated
​7 days
​Frozen (preferred)
​14 days
Rejection Criteria

Gross hemolysis, Gross icterus

Interference

​Alkaline phosphatase (ALP) Isoenzyme:
-High concentrations of phosphate, oxalate, citrate, and cyanide will inhibit ALP activity.
-Excess glycine may inhibit ALP activity by complexing magnesium.
-Patients should be fasting. Patients may have an elevated intestinal ALP about two hours after a fatty meal.

Useful For

​Aid in the diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases​

Determining the tissue source of increased alkaline phosphatase (ALP) activity in serum

Differentiating between liver and bone sources of elevated ALP

Reference Range Information
Performing LocationReference Range
​Mayo Clinc Laboratories
​

ALKALINE PHOSPHATASE

Males

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 116-468 U/L

15-<17 years: 82-331 U/L

17-<19 years: 55-149 U/L

> or =19 years: 40-129 U/L

Females

0-14 days: 83-248 U/L

15 days-<1 year: 122-469 U/L

1-<10 years: 142-335 U/L

10-<13 years: 129-417 U/L

13-<15 years: 57-254 U/L

15-<17 years: 50-117 U/L

> or =17 years: 35-104 U/L

 

ALKALINE PHOSPHATASE ISOENZYMES

Ages:

< or =17 years: Refence values have not been established for patients less than 18 years of age.

> or =18 years:

Liver %: 30.2-74.7

Liver U/L: 15.8-71.9

Bone %: 23.8-68.3

Bone U/L: 12.0-56.7

Intestine %: < or =22.5

Intestine U/L: < or =12.6

Interpretation

​​Liver alkaline phosphatase (ALP) isoenzyme is most frequently elevated when total ALP is elevated. Increased liver ALP is associated with a wide group of conditions including acute hepatitis, cirrhosis, fatty liver, drug induced liver disease, obstruction of biliary flow, bile duct stricture, primary biliary cirrhosis, and metastatic carcinoma of the liver.​

Bone ALP is elevated due to increased osteoblastic activity. Abnormally elevated bone ALP may be indicative of bone tumors, Paget's disease, or renal rickets.

Intestinal ALP is detectable in approximately 20% of samples tested. Intestinal ALP is most frequently noted postprandially in patients with blood group O or B.

For more information visit:
Performing Laboratory Information
Performing LocationDay(s) Test PerformedAnalytical TimeMethodology/Instrumentation
​Mayo Clinic Laboratories
​Tuesday through Saturday
​​3-5 days
​ALP: Colorimetric
ALPI: Electrophoresis
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPTModifier
(if needed)		QuantityDescriptionComments
84075​
​​1
​
​84080
​​1
​​
For most current information refer to the Marshfield Laboratory online reference manual.