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Hypophosphatasia (/ ˌ h aɪ p oʊ ˈ f ɒ s f eɪ t ˌ eɪ ʒ ə /; also called deficiency of alkaline phosphatase, phosphoethanolaminuria, [5] or Rathbun's syndrome; [1] sometimes abbreviated HPP [6]) is a rare, and sometimes fatal, inherited [7] metabolic bone disease. [8]
Laboratory findings include low-normal serum calcium, moderately low serum phosphate, elevated serum alkaline phosphatase, and low serum 1,25 dihydroxy-vitamin D levels, hyperphosphaturia, and no evidence of hyperparathyroidism. [8] Hypophosphatemia decreases 2,3-bisphosphoglycerate (2,3-BPG) causing a left shift in the oxyhemoglobin curve.
The clinical laboratory evaluation of rickets begins with assessment of serum calcium, phosphate, and alkaline phosphatase levels. In hypophosphatemic rickets, calcium levels may be within or slightly below the reference range; alkaline phosphatase levels will be significantly above the reference range.Biochemically, XLH is recognized by ...
In the United States, asfotase alfa is indicated for the treatment of people with perinatal/infantile- and juvenile-onset hypophosphatasia (HPP). [5]In the European Union, asfotase alfa is indicated for long-term enzyme replacement therapy in people with paediatric-onset hypophosphatasia to treat the bone manifestations of the disease.
Treatment efforts may involve many clinical and diagnostic manoeuvers, such as trying to decrease phosphate, [7] normalize vitamin D (calcidiol levels) or decrease PTH and/or alkaline phosphatase levels. [8] However, there is an important lack of randomized clinical studies and recent guidelines (KDIGO 2017) have been recently released on the ...
The enzyme alkaline phosphatase (ALP, alkaline phenyl phosphatase) is a phosphatase with the physiological role of dephosphorylating compounds. The enzyme is found across a multitude of organisms, prokaryotes and eukaryotes alike, with the same general function, but in different structural forms suitable to the environment they function in. Alkaline phosphatase is found in the periplasmic ...
Diagnosis is generally based on blood tests finding a low calcium, low phosphorus, and a high alkaline phosphatase together with X-rays. [2] Prevention for exclusively breastfed babies is vitamin D supplements. [5] Otherwise, treatment depends on the underlying cause. [2] If due to a lack of vitamin D, treatment is usually with vitamin D and ...
The major factor is an abnormally low vitamin D concentration in blood serum. [13] Major typical biochemical findings include: [19] Low serum and urinary calcium; Low serum phosphate, except in cases of renal osteodystrophy; Elevated serum alkaline phosphatase (due to an increase in compensatory osteoblast activity)
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