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HelpTest Code Epic LAB741 Alkaline Phosphatase, Total and Isoenzymes, Serum
Additional Codes
SQ code ALKIMM
Mayo code ALKI
Reporting Name
Alkaline Phosphatase, Tot and Iso,SSpecimen Type
SerumPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Diagnosis and treatment of liver, bone, intestinal, and parathyroid diseases
Determining the tissue source of increased alkaline phosphatase (ALP) activity in serum
Differentiating between liver and bone sources of elevated ALP
Necessary Information
Patient's age and sex are required.
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL, divided
Collection Instructions: Centrifuge and aliquot serum into 2 tubes, each containing 0.5 mL
Specimen Minimum Volume
0.5 mL divided into 2 tubes each containing 0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Frozen (preferred) | 14 days | |
| Ambient | 7 days | ||
| Refrigerated | 7 days |
Reference Values
ALKALINE PHOSPHATASE
Males
0-14 days: 83-248 U/L
15 days-<1 year: 122-469 U/L
1-<10 years: 142-335 U/L
10-<13 years: 129-417 U/L
13-<15 years: 116-468 U/L
15-<17 years: 82-331 U/L
17-<19 years: 55-149 U/L
≥19 years: 40-129 U/L
Females
0-14 days: 83-248 U/L
15 days-<1 year: 122-469 U/L
1-<10 years: 142-335 U/L
10-<13 years: 129-417 U/L
13-<15 years: 57-254 U/L
15-<17 years: 50-117 U/L
≥17 years: 35-104 U/L
ALKALINE PHOSPHATASE ISOENZYMES
Liver 1%
0-6 years: 5.1-49.0%
7-9 years: 3.0-45.0%
10-13 years: 2.9-46.3%
14-15 years: 7.8-48.9%
16-18 years: 14.9-50.5%
≥19 years: 27.8-76.3%
Liver 1
0-6 years: 7.0-112.7 IU/L
7-9 years: 7.4-109.1 IU/L
10-13 years: 7.8-87.6 IU/L
14-15 years: 10.3-75.6 IU/L
16-18 years: 13.7-78.5 IU/L
≥19 years: 16.2-70.2 IU/L
Liver 2%
0-6 years: 2.9-13.7%
7-9 years: 3.7-12.5%
10-13 years: 2.9-22.3%
14-15 years: 2.2-19.8%
16-18 years: 1.9-12.5%
≥19 years: 0.0-8.0%
Liver 2
0-6 years: 3.0-41.5 IU/L
7-9 years: 4.0-35.6 IU/L
10-13 years: 3.3-37.8 IU/L
14-15 years: 2.2-32.1 IU/L
16-18 years: 1.4-19.7 IU/L
≥19 years: 0.0-5.8 IU/L
Bone %
0-6 years: 41.5-82.7%
7-9 years: 39.9-85.8%
10-13 years: 31.8-91.1%
14-15 years: 30.6-85.4%
16-18 years: 38.9-72.6%
≥19 years: 19.1-67.7%
Bone
0-6 years: 43.5-208.1 IU/L
7-9 years: 41.0-258.3 IU/L
10-13 years: 39.4-346.1 IU/L
14-15 years: 36.4-320.5 IU/L
16-18 years: 32.7-214.6 IU/L
≥19 years: 12.1-42.7 IU/L
Intestine %
0-6 years: 0.0-18.4%
7-9 years: 0.0-18.3%
10-13 years: 0.0-11.8%
14-15 years: 0.0-8.2%
16-18 years: 0.0-8.7%
≥19 years: 0.0-20.6%
Intestine
0-6 years: 0.0-37.7 IU/L
7-9 years: 0.0-45.6 IU/L
10-13 years: 0.0-40.0 IU/L
14-15 years: 0.0-26.4 IU/L
16-18 years: 0.0-12.7 IU/L
≥19 years: 0.0-11.0 IU/L
Placental
Not present
Day(s) Performed
Monday through Friday
Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84075
84080
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ALKI | Alkaline Phosphatase, Tot and Iso,S | 24332-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ALP | Alkaline Phosphatase, S | 6768-6 |
| 89503 | Alkaline Phosphatase Isoenzymes, S | 49243-9 |
| 45488 | Liver 1 % | 15348-6 |
| 57034 | Liver 1 | 13874-3 |
| 45489 | Liver 2 % | 15349-4 |
| 57035 | Liver 2 | 13875-0 |
| 45490 | Bone % | 15013-6 |
| 57036 | Bone | 1777-2 |
| 45491 | Intestine % | 15014-4 |
| 57037 | Intestine | 1778-0 |
| 29324 | Placental | 40793-2 |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
ALP: Colorimetric
ALKE: Electrophoresis
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ALP | Alkaline Phosphatase, S | Yes | Yes |
| ALKE | Alkaline Phosphatase Isoenzymes, S | No | Yes |
Method Description
Total Alkaline Phosphatase:
In the presence of magnesium and zinc ions, p-nitrophenyl phosphate is cleaved by phosphatases into phosphate and p-nitrophenol. The p-nitrophenol released is directly proportional to the catalytic alkaline phosphatase (ALP) activity. It is determined by measuring the increase in absorbance.(Package insert: Alkaline Phosphatase reagent. Roche Diagnostics; 02/2012)
ALP Isoenzymes:
Serum samples are electrophoresed through alkaline buffered (pH 9.1) agarose gels. Almost all ALP isoenzymes can be separated by electrophoresis according to their charge difference. However, because the electrophoretic mobilities of the liver and bone isoenzymes are quite similar, a modification is required for separation. The Sebia system utilizes differences between liver and bone isoenzyme sialation to achieve separation. Each sample is applied to the agarose gel in duplicate. One sample is passed through wheat germ lectin (wheat germ agglutin:WGA) and is deposited anodally from the point of sample application. The bone isoenzyme, which is rich in sialic acids, reacts with WGA and precipitates adjacent to the lectin application point. The separated isoenzymes are visualized using a specific chromogenic substrate, 5-bromo-4-chloro-3-indolyl phosphate/nitro blue tetrazolium in aminomethyl propanol (AMP) buffer, pH 10.0. The dried gels are read on a densitometer for the quantification of tissue isoforms.(Package insert: Sebia Hydragel 7 and 15 ISO-PAL. Sebia; 01/2017)