What is Endocrinology - Which laboratory test ought to be used to keep tabs on Paget's disease patients?
Alkaline phosphatase levels may be normal when Paget's disease is predominantly lytic. The serum alkaline phosphatase activity otherwise often correlates with other chemical markers of bone resorption. As a result, in the majority of instances with Paget's disease, the total serum alkaline phosphatase concentration is the most straightforward and affordable laboratory value for tracking the course and the response to treatment. It's interesting to note that widespread disease in the rest of the skeleton without involvement of the skull is sometimes associated with more modest elevations of serum alkaline phosphatase, whereas a markedly elevated alkaline phosphatase concentration (e.g., 10 times the upper limit of normal) is typically associated with pagetic involvement of the skull. Since liver and bone both contain large amounts of this enzyme, liver illness should be ruled out in patients with elevated total alkaline phosphatase values. It is likely that the high alkaline phosphatase value comes from bone if liver-specific tests, such as those for 59-nucleotidase, gamma-glutamyl transpeptidase, or the liver alkaline phosphatase isoenzyme, are normal.
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