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DS1, 5, has raised alkaline phosphatase levels, anyone know anything about this?

(16 Posts)
Pesha Fri 12-Sep-08 23:06:01

Have been googling (well yahooing actually but ykwim!), I know I shouldn't but I cant find anything that corresponds with what the dr told me.

He had routine blood tests because since about easter he has become very lethargic and grumpy and miserable. He does have bursts of enegy sometimes but nothing like he used to be, he used to be manic! He also seems to quite often have tummy ache and I think he has lost weight, he is certainly much slimmer than he was. At first I put it down to the strain of school (hes an August baby and is struggling) but when it carried on all through the summer holidays I began to wonder if there was something physical behind it.

Anyway he had the blood tests and all are normal except the ALP. When I rang for the results I was told the dr just wanted to 'phone me, when he did he was very cagey and wouldn't say what levels were high at first just that it was one of the liver tests and it was nothing to worry about but he said now we've started looking into this we should follow it up so he made an appointment for monday (which I changed to this afternoon as DS1 is away next week). When I saw the Dr she said that he has probably been fighting an infection and this has caused his levels to be high. She wants to test again in 4 weeks to check they have returned to normal.

In my searching I have found things that say its quite common to have raised levels in children due to rapid bone formation (these are bone alp levels, are they different to liver alp? Would it show in these test results?) but nothing at all anywhere about infection possibly raising levels.

I'm not panicing about this I am just a bit confused! I know obviously the Drs are medically trained and I'm just searching web sites but I have lost faith in some of the Drs at my surgery and the other Dr's caginess hasn't helped.

I just wondered if there was someone who knows about this and could maybe explain a bit more please?

Pesha Sat 13-Sep-08 11:03:10

Anyone?!

BoysAreLikeDogs Sat 13-Sep-08 11:13:33

Blimey Pesha the doctor has not been very helpful [understatement]

Any chance you can pester the doctor for a full explanation of what they are looking for.

Have had a google but as a lay person could make neither head nor tail of most of the articles I turned up.

Good luck.

BoysAreLikeDogs Sat 13-Sep-08 11:34:34

Bumping for my mate

smile

Pesha Sat 13-Sep-08 12:23:39

Thanks BALD smile I was talking to my friend last night and have decided I will go back and see the Dr I saw originally, who was very good, and see if he can explain a bit more. When I saw him with my initial concerns he said they would do the blood tests and if they came back normal then he would refer DS to a peadiatrician so did seem to be taking me seriously which is reassuring.

I read one thing that said raised ALP on their own can be nothing to worry about but if combined with other symptoms of diseases that can cause raised ALP levels then it should be investigated. Well Nathan's symptoms are tiredness, stomach pain, nausea, achey legs quite often and a few other little things which can be symptoms of some liver conditions.

I realise a little knowledge is a dangerous thing and it probably is nothing. And I hate going to the Dr, who has spent years training to get where he is, saying 'I read this on the internet after a half hour search and think I know better than you!' But I would like a better explanation than I had before and to be able to discuss my concerns with someone.

bettyanne Sat 13-Sep-08 19:59:05

Hi Pesha

my Ds who is now nearly two, had extremely hight ALT levels at the end of last year.

Normal range is somewhere around about the hundred mark his were over 5000!!!

The results were picked up accidentally during blood tests for something else completely unrelated.

I had a complete meltdown when I found this out and the Consultant said he had only seen about 5 other children with levels this high. Despite all this, and importantly, he said that the condition, which in DP's case was benign hyperphosphataemia, did not mean he was ill. The cause is not yet known but if all the other liver results are normal then ^everything is fine^.

Ds was tested for rickets (I must admit to having found this mildly amusing as he eats like a horse anything and everything!) as sometimes the high ALT can be caused by this. As I suspected-negative.

Am saying all this to point out that the liver does do some odd things, my own ALT levels were high recently, I dont drink or take any meds and the gp was totally unconcerned. Most likely your little one has had a little infection and the liver, being the detox centre of the body, has taken a little knock. I believe, having had this experience with dp, that there are further blood tests can be done to dtermine if it really is the liver thats releasing the ALT or if its another system in the body.

Try not to worry too much and definately go back to the GP, they are there to explain/reassure as well as diagnose don't forget!

Pesha Sun 14-Sep-08 19:39:04

Thanks for that Bettyanne. Can't believe how high your ds's levels were! But thats very interesting that they were that high and perfectly ok.

The thing that worries me slightly I think is his other symptoms combined with the test results but it is reassuring to hear about your ds.

I will definitely be going back to the Dr tomorrow to discuss it some more with him.

Thanks again smile

Joolyjoolyjoo Sun 14-Sep-08 19:45:45

Hi, not sure I can help much, but I'm a vet and (in animals at least!) ALKP (aka ALP) is not a liver-specific marker- it can be raised for lots of reasons, including, as you say, growth, inflammation, steroid meds and others. You would have to look at the rest of the picture. Did they do a complete blood count too- High levels of white blood cells would suggest infection/ imflammation, or even other endocrine disorders?

Not sure if this helps- I am my doctor's worst nightmare, as I relate everything back to animals, but the principle is usually the same!

Pesha Sun 14-Sep-08 21:09:03

Lol, before my sister had her DD we had a many a conversation where we would compare the behaviour and similarities of her dogs and my dc! grin Although perhaps that says a lot about my dc hmm

It is helpful though, thank you. I have not been able to find anything on the internet about infection raising levels so reassuring to hear from others that it does. Not sure why its not mentioned hmm

I don't know if a full blood count was done, I've not actually been shown the results so may ask to see them tomorrow. The Dr did say though that all the other tests they had done were fine.

WobblyPig Sun 14-Sep-08 21:13:42

The alkp level won't distinguish between bone and live. Are all the other liver enzymes normal? Has he broken any bones recently? You mention tummy pain and loss of energy could he have coeliac disease? - OUTSIDE POSSIBILITY so please don't worry but ask the GP.

Pesha Sun 14-Sep-08 21:29:43

He just had routine blood tests and they were all normal except for the alkp afaik, don't know specifically what they were though.

My grandmother had coeliac disease and I did mention that to the GP I saw who first sent him for the tests as it had crossed my mind. I am going to try and see the same GP tomorrow, he seemed very good and knows the history so will hopefully be more helpful than the one I saw last week. Could the alkp (alp, ap?!) levels be raised because of Coeliac disease at all or were you just asking because of his other symptoms?

No broken bones at all ever.

bettyanne Mon 15-Sep-08 21:55:17

Hi Pesha

Just wondering how you and your ds got on today- hope you have had some reassurrance-its such a worry when you have a little one who isn't as well as they usually are!

Hope all went well.

Pesha Mon 15-Sep-08 22:47:04

Hi Bettyanne, thanks for your concern smile

Dr was very good, has referred ds for liver function tests in 4 weeks, as the other Dr had, but also for a GGT test which should help clarify the ALP test and show more if there is a liver problem or not, and also for a coeliac disease test.

After wobblypig's post i looked at coeliac symptoms some more and he does seem to have quite a lot of the symptoms so I did push the Dr on this a little!

Just have to wait what will no doubt be a very long 4 weeks now! I just want to know whats causing my little boy to be so different and so miserable so I can get on and try and do something about it iyswim. And if its not physical then I think it must be school and I don't quite know what I'll do about that. But thats a whole other thread!!

dandandan Tue 16-Sep-08 18:27:01

ALP is done as part of a liver screen or part of a bone screen. You can test for specific ALP isoenzymes (bone or liver) but it is expensive so most places do gamma glutamyl transferase (GGT). Do you know if this was done?

Pesha Tue 16-Sep-08 18:31:47

No but they are going to do the GGT in 4 weeks when they do all the LFTs again and also they are going to test for Coeliac disease then.

dandandan Tue 16-Sep-08 18:39:08

If the ggt raised then its from liver if not its more than likely its bone and you would expect a raised alp in a 5 year old. Depends what the level is and what the labs reference ranges are.

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