Lab Information Manual

Laboratory:

Clinical Biochemistry (AUTOMATED)

Test Name:

ALKALINE PHOSPHATASE (ALP), WRHA & Westman Lab (ROCHE) - (P)

Test Code: ALK

Clinical Information:

Test Indications: Serum alkaline phosphatase consists of four structurally similar enzymes (isoenzymes) depending where it is produced: liver-kidney-bone type, intestinal, placental and germ cell. The liver-kidney-bone type is particularly important. It is elevated in liver disease, disorders of the skeletal system, with fractures, and malignant tumors. Alkaline phosphatase activity is also seen in children and juveniles due to osteoblast activity associated with accelerated bone growth.
ALP testing is used for diagnosing and monitoring the treatment of liver, bone, intestinal and parathyroid diseases.

Patient preparation instructions: This test is unaffected by multivitamins (45–125 µg biotin) or biotin-only supplements.

Collection Devices:

Preferred Device:	1 - Li Heparin Plasma Separator Tube(s) - Full Tube Collection Li Heparin Plasma Separator Tube(s) - Full Tube Collection Manufacturer: BD (Becton Dickinson) Catalogue #: 367962
Alternate Device:	1 - Microtainer(s) - Li Heparin PST (0.6mL) to fill line Microtainer(s) - Li Heparin PST (0.6mL) to fill line Manufacturer: Becton Dickinson & Company Catalogue #: 365987

Specimen Required:

Plasma: 2.0 mL

Pediatric Plasma: 0.2 mL

Stability 7 days refrigerated, 2 months frozen

Referral:

Serum: 2.0 mL

Shipping & Storage: Samples must be transferred to an aliquot tube and stored/shipped

· Refrigerated if off-site testing to be performed within 48 hours of collection

· Frozen if testing to be performed after 48 hours

See #110-10-05 Serum / Plasma Separation Procedure & Transport

Requisition:

_SH Biochemistry Hematology Requisition (R250-10-92)

_SH Hospital Biochemistry Hematology Non Winnipeg Brandon (R250-10-91)

_SH Winnipeg Brandon Biochemistry Hematology Requisition (R250-10-94)

_SH Winnipeg Brandon Hospital Biochemistry Hematology Requisition (R250-10-93)

Reference Values:

Age	Male	Female
0-14 d	83-248 U/L
15d - 12 m	122-469
1-9 y	142-335
10-12 y	129-417
13-14 y	116-468	57-254
15-16 y	82-331	50-117
17-18 y	55-149	35-104
≥ 19 y	40-129	35-104

Females (15-50 y): In pregnancy twice normal in 3^rd trimester

If ALP less than or equal to 30 U/L: “Patients with low alkaline phosphates levels: A low level can occur in various medical conditions and may be a marker for hypophosphatasia, a now potentially treatable disorder of bone mineralization. For further information please contact the metabolic geneticist on call through HSC paging (787-2071).”

Method of Analysis: Roche Enzymatic rate

Availability:

Daily