Verma Jitin, Gorard David A
Department of Gastroenterology, Wycombe Hospital, High Wycombe, UK.
BMJ Case Rep. 2012 Aug 24;2012:bcr2012006768. doi: 10.1136/bcr-2012-006768.
A 32-year-old overweight asymptomatic man was found to have a persistently raised serum alkaline phosphatase at 250-300 U/l (normal range <130). Other liver function tests were unremarkable apart from an initial marginally elevated alanine transaminase, which normalised with weight reduction. Abdominal imaging revealed a fatty liver but an extensive serological search for significant hepatobiliary disease was negative. Subsequent isoenzyme electrophoresis revealed normal liver and bone fractions of alkaline phosphatase but a grossly elevated intestinal fraction. Elevated intestinal fraction of alkaline phosphatase should be considered in the investigation of unexplained alkaline phosphatase, particularly when the usual associated hepatobiliary and bony pathologies are not present. Although an elevated intestinal fraction of alkaline phosphatase can be linked to significant gastrointestinal pathology, this case report highlights that it can be a benign biochemical finding.
一名32岁超重的无症状男性被发现血清碱性磷酸酶持续升高，为250 - 300 U/l（正常范围<130）。除了最初轻度升高的丙氨酸转氨酶外，其他肝功能检查均无异常，该转氨酶在体重减轻后恢复正常。腹部影像学检查显示为脂肪肝，但对严重肝胆疾病进行的广泛血清学检查结果为阴性。随后的同工酶电泳显示碱性磷酸酶的肝脏和骨骼部分正常，但肠道部分显著升高。在对不明原因的碱性磷酸酶升高进行调查时，应考虑碱性磷酸酶肠道部分升高的情况，特别是当不存在常见的相关肝胆和骨骼病变时。虽然碱性磷酸酶肠道部分升高可能与严重的胃肠道病变有关，但本病例报告强调这可能是一种良性的生化表现。
