Kikuchi S, Fujikawa S, Hara K, Ohira M, Kojima C, Maekawa M
Division of Clinical Laboratory, National Cancer Center Hospital, Tokyo.
Rinsho Byori. 1997 Aug;45(8):795-800.
A detailed time course of alkaline phosphatase (ALP; EC3.1.3.1) activity of transient hyperphosphatasemia (TH) in a 9-year-old boy with acute lymphoblastic leukemia (ALL) is described. The patient's serum ALP activity rose transiently to 49 times the upper limit of normal adult, without any evidences of hepatic and bone disease. The half-life of ALP activity was calculated about 10 days. We characterized ALP isoenzymes by usual electrophoresis using cellulose acetate membrane (Titan III iso-vis) and polyacrylamide disc gel (AlkPhor), and isoelectric focusing using polyacrylamide slab gel. The former two methods showed typical two bands (fast-alpha 2 and alpha 2 beta bands) and the latter one method revealed more basic bands of liver and bone, suggesting the extensive sialylation. The patient complained fever and diarrhea. Enterococcus faecium was detected from his stool. Etiologically, two more patients in the same ward showed TH in the same period. It suggested TH would be occurred by infectious states. Awareness of such benign forms of hyperphosphatasemia not related to malignancy will aid the physician in the differential diagnosis of elevated ALP activity.
本文描述了一名9岁急性淋巴细胞白血病（ALL）男孩短暂性高磷酸酶血症（TH）患者碱性磷酸酶（ALP；EC3.1.3.1）活性的详细时间进程。患者血清ALP活性短暂升至正常成人上限的49倍，且无任何肝脏和骨骼疾病的证据。计算得出ALP活性的半衰期约为10天。我们通过使用醋酸纤维素膜（Titan III等渗）和聚丙烯酰胺圆盘凝胶（AlkPhor）的常规电泳以及使用聚丙烯酰胺平板凝胶的等电聚焦来对ALP同工酶进行表征。前两种方法显示出典型的两条带（快速α2和α2β带），后一种方法揭示了肝脏和骨骼的更多碱性带，提示存在广泛的唾液酸化。患者主诉发热和腹泻。从其粪便中检测到粪肠球菌。从病因学角度来看，同一病房的另外两名患者在同一时期也出现了TH。这表明TH可能由感染状态引起。认识到这种与恶性肿瘤无关的良性高磷酸酶血症形式将有助于医生对ALP活性升高进行鉴别诊断。
