Alkaline Phosphatase - PDF

By: Dr. Safinaz Hamdy El Khoulany Lecturer of Medical Biochemistry and Molecular Biology  Alkaline Phosphat - ase It is stable and It removes works best in phosphate Enzyme an alkaline groups from medium molecule...

By: Dr. Safinaz Hamdy El Khoulany Lecturer of Medical Biochemistry and Molecular Biology  Alkaline Phosphat - ase It is stable and It removes works best in phosphate Enzyme an alkaline groups from medium molecules It dephosphorylates compounds so that the molecule can freely diffuse into the cell Don’t confuse Alkaline phosphatase with Acid phosphatase Acid phosphatase : - Works in an acidic environment - Monitors response to treatment in prostate cancer - Differentiate between: - B- type acute lymphoblastic leukemia (B-ALL) - Acid phosphatase -ve - T- type acute lymphoblastic leukemia (T-ALL) - Acid phosphatase +ve  Sites of Alkaline Phosphatase It is present in all tissues especially: Bone liver (especially hepatobiliary system) Mature WBCs Kidneys Placenta  Sites of Alkaline Phosphatase It is present in all tissues especially: Bone liver (especially hepatobiliary system) Mature WBCs Kidneys Placenta  High levels Low levels Biliary disease (cholecystitis or gallstones) Wilson disease Liver disease (Hepatitis or Cirrhosis) Bone diseaes with excessive bone formation (Paget disease) Excessive bone formation (Children and adolescents) Kidney tumors Pregnancy Postmenopause Hyperthyroidism Hypothyroidism Hyperparathyroidism Leukomoid reaction Chronic myeloid leukemia(CML)  Liver Biliary system -ALT (SGPT) -AST (SGOT) ALP Pancreas -Amylase -Lipase  Leucocyte ALP (LAP) [LAP SCORE] If WBCs are useless “cancer” and less mature If WBCs are or immature It is found in Mature WBCs doing their job and mature They do not uptake the stain They uptake the for ALP into stain for ALP their cytoplasm Low LAP score Immature mature High LAP score  Leucocyte ALP (LAP) [LAP SCORE] If WBCs are useless “cancer” and less mature If WBCs are or immature It is found in Mature WBCs doing their job and mature They do not uptake the stain They uptake the for ALP into stain for ALP their cytoplasm Low LAP score Immature mature High LAP score  Immature mature leukemoid reaction (not cancer): Increased white blood cell count (> 50,000 cells/μL), which is a physiological response to stress or infection Leukemia (Cancer): Malignancy arising from the bone marrow causing increased white blood cell count (10,000 – 100,000 cells/μL) and is characterized by the presence of immature cells (blasts) In cancer (leukemia), there is left shifting In Acute myeloid leukemia (AML), cells are very immture In Chronic myeloid leukemia (CML), cells are more mature but not like normal cells  Leucocyte ALP (LAP) [LAP SCORE] It is found in Mature WBCs AML CML leukemoid Aplasic anemia reaction Low LAP score Immature mature High LAP score Aplastic anemia is a disease in which the body fails to produce blood cells in sufficient numbers. Blood cells are produced in the bone marrow by stem cells. It causes a deficiency of all blood cell types: red blood cells, white blood cells, and platelets