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Fosfatasas alcalinas altas: Qué son y por qué se elevan
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Fosfatasas alcalinas altas: Qué son y por qué se elevan

What Are Elevated Alkaline Phosphatase Levels?

Introduction to Alkaline Phosphatase

  • The speaker, Dr. Alejandro Sosa, introduces the topic of elevated alkaline phosphatase levels and their potential link to liver disease.
  • Alkaline phosphatase (ALP) is an enzyme measured in blood tests, often as part of a biochemical profile; normal values can be higher in children and adolescents, with a typical upper limit of 120 IU/L.

Causes of Elevated Alkaline Phosphatase

  • ALP is primarily found in three tissues: bone, placenta, and liver; elevations may indicate issues within these areas.
  • In children or adolescents, elevated ALP levels are often due to normal growth processes rather than pathology.
  • During the third trimester of pregnancy, placental growth can also lead to increased ALP levels.

Clinical Significance of Elevated Levels

  • The most critical cause for elevated ALP is liver problems; it indicates reduced bile elimination from the liver.
  • Symptoms accompanying elevated ALP that suggest hepatic origin include:
  • Jaundice: Yellowing of skin and eyes due to bile accumulation.
  • Dark Urine: Resembling cola or strong tea color.
  • Pruritus: Intense itching associated with cholestatic diseases.

Diagnostic Approach

  • A follow-up test measuring gamma-glutamyl transferase (GGT) is typically requested; high GGT alongside elevated ALP confirms a hepatic source for the elevation.
  • Imaging studies such as abdominal ultrasound or CT scans are performed next to check for biliary obstruction or assess liver condition.

Investigating Biliary Obstruction

  • If biliary obstruction is suspected, two main causes should be investigated:
  • Gallstones: Often originating from the gallbladder and migrating into the bile duct.
  • Tumors: Can occur within the bile duct or pancreas (especially head of pancreas), leading to obstruction.

Intrahepatic Causes When No Obstruction Found

  • If no obstruction exists, intrahepatic issues are considered. Common conditions include:
  • Primary Biliary Cholangitis: More prevalent in women aged 30–60 years.
  • Medication Toxicity: Certain drugs can elevate ALP levels significantly.
  • Primary Sclerosing Cholangitis: An autoimmune disease affecting bile ducts.
Video description

Las fosfatasas alcalinas son enzimas que pueden elevarse en enfermedades del hígado. En este video se explica qué son las fosfatasas alcalinas, por qué pueden estar altas las fosfatasas alcalinas y cómo aproximarse al diagnóstico. 00:00 Introducción 00:29 Qué son las fosfatasas alcalinas 00:53 Causas de elevación de fosfatasas alcalinas 02:09 Síntomas de fosfatasas alcalinas elevadas (ictericia, coluria, prurito) 03:00 Diagnóstico de fosfatasas alcalinas altas: Uso de la GGT e imágenes 03:49 Obstrucción de la vía biliar: Cálculos biliares, tumores 04:21 Colestasia intrahepática: Colangitis biliar primaria, medicamentos, colangitis biliar primaria 05:07 Resumen Esta información sólo tiene fines educativos. Consulte siempre a su médico.