Table 1

 Differential diagnosis of raised serum alkaline phosphatase concentrations with regard to the origin of isoenzymes

Tissue non-specific isoenzymePlacental isoenzymeIntestinal isoenzyme
IUGR, intrauterine growth restriction.
Normal tissue originEarly placenta (<10 weeks)Term placentaIntestine
LiverUterus
BoneTestis
Kidney
Bone diseasesFracture
Paget’s disease
Rachitis
Osteomalacia
D-Hypervitaminosis
Osteogenesis inperfecta
Osteoporosis
Hepatic diseasesHepatitisCholestasisCirrhosis
Obstructive icterusGilbert syndrome
Primary biliary cirrhosis
Cholestasis
Renal diseaseRenal failureRenal failure
Chronic renal disease
Endocrine diseasesHyperthyroidismDiabetes mellitus
Hyperparathyroidism
Acromegaly
Cushing’s syndrome
Malignant tumoursHepatocellular carcinomaOvarian carcinoma
Bone sarcomaPancreas carcinoma
LymphomaGastric carcinoma
Bone and liver metastasis
Pregnancy related diseasesIUGR Down’s syndrome
Pre-eclampsia
Drug treatmentAntiepileptic treatmentSteroid treatment
OthersHeavy smoking