Massey G V, Dunn N L, Heckel J L, Chan J C, Russell E C
Department of Pediatrics, Children's Medical Center, Virginia Commonwealth University, Richmond 23298-0121, USA.
Clin Pediatr (Phila). 1996 Oct;35(10):501-4. doi: 10.1177/000992289603501004.
A temporary elevation of serum alkaline phosphatase has been described in young children who have no evidence of liver or bone disease. This phenomenon has been termed benign hyperphosphatasemia of infancy. Its occurrence is described in three children undergoing chemotherapy for acute lymphoblastic leukemia and lymphoma. All three children were in remission and in the consolidation or maintenance phase of their therapy when the hyperphosphatasemia occurred. All children were also receiving methotrexate (IM and IV), oral 6-mercaptopurine, and oral sulfamethoxazole/trimethoprim. Although these agents are associated with hepatotoxicity, other liver transaminases (ALT, AST) remained at normal concentrations, and there was an elevation only in the bone isoenzyme of alkaline phosphatase, thus making hepatic toxicity an unlikely etiology for the hyperphosphatasemia. No alteration in chemotherapy was necessary for resolution of the elevated alkaline phosphatase in these children.
在没有肝脏或骨骼疾病证据的幼儿中，曾有血清碱性磷酸酶暂时升高的情况被描述。这种现象被称为婴儿良性高磷酸酶血症。本文描述了三名接受急性淋巴细胞白血病和淋巴瘤化疗的儿童出现了这种情况。高磷酸酶血症发生时，所有三名儿童均处于缓解期且处于治疗的巩固或维持阶段。所有儿童还同时接受甲氨蝶呤（肌肉注射和静脉注射）、口服6-巯基嘌呤以及口服磺胺甲恶唑/甲氧苄啶。尽管这些药物与肝毒性有关，但其他肝转氨酶（ALT、AST）仍保持在正常浓度，仅碱性磷酸酶的骨同工酶升高，因此肝毒性不太可能是高磷酸酶血症的病因。这些儿童碱性磷酸酶升高的情况无需改变化疗方案即可缓解。
