Abstract
A patient with cholestatic jaundice and normal serum alkaline phosphatase was found to have low levels of the enzyme before and after this illness. It is suggested that this patient has hypophosphatasia because of the low serum alkaline phosphatase, a leukocyte alkaline phosphatase value of zero, and increased excretion of urinary phosphoethanolamine to 12 times normal. There were no bony abnormalities except for osteoporosis compatible with his age and some old rib fractures that followed trauma. His serum magnesium, B12, and thyroid function tests were normal.
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