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Abstract
Transient hyperphosphatasemia (TH) is a benign condition in which serum alkaline phosphatase (ALP) is transiently elevated in the absence of other systemic diseases. It rarely occurs in infants and children under 5 years and is very rarely seen in adults. The differential diagnosis may include bone, intestinal, liver, kidney, intestinal, placental and blood diseases as well as other serious conditions, as well as bone fracture due to accidental or non-accidental injuries. The exclusion of such differential diagnosis before establishing the diagnosis of TH is crucial. We present a case of a nine-month-old girl who was found to have transient hyperphosphatasemia, while she was being investigated for failure to thrive. This case report aims to reinforce that hyperphosphatasemia is a benign phenomenon and diagnostic procedures that are invasive and costly should be avoided.
Highlights
The benign elevation of alkaline phosphatase (ALP) is referred to as transient hyperphosphatasemia (TH) and is occasionally observed in infants and children younger than 5 years of age, without evidence of bone, gastrointestinal or liver disease on history taking, physical examination or laboratory investigations[1,2] It has no adverse long-term consequences[3,4]
We present a case of a nine-month-old girl who was found to have transient hyperphosphatasemia, while she was being investigated for failure to thrive
Recognition and differentiation of transient hyperphosphatesemia from bone, liver, renal and intestinal pathology is important to avoid unnecessary investigations[3]. It needs to be differentiated from familial hyperphosphatesemia, which is inherited in an autosomal dominant manner and is associated with persistent and asymptomatic elevation of alkaline phosphatase levels
Summary
The benign elevation of alkaline phosphatase (ALP) is referred to as transient hyperphosphatasemia (TH) and is occasionally observed in infants and children younger than 5 years of age, without evidence of bone, gastrointestinal or liver disease on history taking, physical examination or laboratory investigations[1,2] It has no adverse long-term consequences[3,4]. We present a case of a nine-month-old girl who was found to have transient hyperphosphatasemia, while she was being investigated for failure to thrive. In the literature correlating transient rise in alkaline phosphatase to upper respiratory tract infections or gastro enteritis[6].
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