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Old 08-30-2012
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Question alkaline phosohatase

Osteopetrosis inc ALP ? normal?
Osteomalacia inc ALP? always knew it to be normasl until i met a q...
Vitamin D intoxication inc ALP or dec? this one has both normal and inc but i wanna b sure
Renal Osteodystrophy inc ALP or dec? i'm thinkn normal but still

Yea... i figure i should know this by now but it still gets all tangled up in my head
help!!
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Old 08-30-2012
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Default it might help

alkaline phosohatase-bone-disease.png

Hope this table will clear some of your doubts.
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Vitamin D intoxication or hypervitaminosis D can cause increased re-absorption of calcium in jejunum and kidney. So Ca2+ will be increased. ALP- i think it will be increased but not sure (as Vit D try to do bone mineralization. So it would need more of Ca and phosphorus. So more hydrolyzation of phosphorus from other sources causes increase in ALP).

In renal osteodystropy: there will be decreased Ca2+ and increased phosphates. Regarding ALP, I am not sure. It seems it will be increased but i would say it would be variable.

It is nice way to organize information for last time revision. So other comments are also welcomed.
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1.ALP in bone indicated that there is osteoblastic activity
2. increased osteoblastic and osteoclastic activity increased ALP which is what happen in Pagets disease
3. There is the same increased activity of osteoblastic and osteoclastic cells in hyperparathyrodism because PTH activates or work in osteoblastic cells, and this ones with the production of cytokines activates osteoclastic cells to start the bone resorption. So that's why in renal osteodystrophy and osteitis fibrousa cystica there's and increased of ALP.

4. In osteoporosis the problem is abnormal function of osteoclasts so serum Ca2+, phosphate ALP and PTH are normal or theres no significant change.
5. In Osteomalacia is variable either no change or slightly increased due to increased PTH

Also remember that when PTH is elevated we can find in urine hydroxy-proline due to increased activity of osteoclast (destroy collagen in bone)

Correct me if I'm wrong
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Good thought but this still doesn't explain why ALP in Renal osteodystrophy is normal. Gud thought though I culd totally relay 2 that......
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Originally Posted by obinocle View Post
Good thought but this still doesn't explain why ALP in Renal osteodystrophy is normal. Gud thought though I culd totally relay 2 that......
where u read it was normal??? in FA it says is increased. if u have a chronic renal disease vitamin D can't be actived, once vitamin D is actived goes to the cell of the small intestine to activated calbinding protein so ca2+ can be absorp in the gut, since this doesn't happen there's decreased Ca2+ and PTH increased so activity of osteablasts and osteoclasts is increased so ALP is going to be increased. There is hyperphosphatemia because since the kidney is not working properly PTH can't work on the cells of proximal tubules to block phosphate/sodium co transporter, So it can't trash phosphate but at the same time is letting free ca2+ and phosphate from bone. So u end up with weak bones and at the same time since the kidney interstitium is alkaline calcium love to bind to alkaline surfaces. Remember that renal osteodystrophy is due to secondary or tertiary hyperparathyrodism
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