Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis

A 28-year-old male with acute on chronic liver failure (ACLF) and hepatic encephalopathy had deranged liver function with curiously low level (0-15 IU/L) of serum alkaline phosphatase (ALP). Peripheral smear examination suggested hemolytic anemia. The finding of persistent low ALP, after ruling out...

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Autores principales: Arora, Parul, Jadaun, Shekhar Singh, Das, Prasenjit, Shalimar, Datta, Sudip K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Communications and Publications Division (CPD) of the IFCC 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416816/
https://www.ncbi.nlm.nih.gov/pubmed/30881280
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author Arora, Parul
Jadaun, Shekhar Singh
Das, Prasenjit
Shalimar,
Datta, Sudip K.
author_facet Arora, Parul
Jadaun, Shekhar Singh
Das, Prasenjit
Shalimar,
Datta, Sudip K.
author_sort Arora, Parul
collection PubMed
description A 28-year-old male with acute on chronic liver failure (ACLF) and hepatic encephalopathy had deranged liver function with curiously low level (0-15 IU/L) of serum alkaline phosphatase (ALP). Peripheral smear examination suggested hemolytic anemia. The finding of persistent low ALP, after ruling out pre-analytical causes, in ACLF has been reported in Wilson’s disease (WD) with/ without autoimmune hemolytic anemia (AIHA). Definitive evidences of WD were not seen in our case. Positive DCT and histological features suggest a diagnosis of autoimmune hepatitis with secondary hemochromatosis and cholangitis. Low ALP might not always be a determinant of bile duct pathology in patients of ACLF with AIHA.
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spelling pubmed-64168162019-03-15 Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis Arora, Parul Jadaun, Shekhar Singh Das, Prasenjit Shalimar, Datta, Sudip K. EJIFCC Case Report A 28-year-old male with acute on chronic liver failure (ACLF) and hepatic encephalopathy had deranged liver function with curiously low level (0-15 IU/L) of serum alkaline phosphatase (ALP). Peripheral smear examination suggested hemolytic anemia. The finding of persistent low ALP, after ruling out pre-analytical causes, in ACLF has been reported in Wilson’s disease (WD) with/ without autoimmune hemolytic anemia (AIHA). Definitive evidences of WD were not seen in our case. Positive DCT and histological features suggest a diagnosis of autoimmune hepatitis with secondary hemochromatosis and cholangitis. Low ALP might not always be a determinant of bile duct pathology in patients of ACLF with AIHA. The Communications and Publications Division (CPD) of the IFCC 2019-03-01 /pmc/articles/PMC6416816/ /pubmed/30881280 Text en Copyright © 2019 International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Arora, Parul
Jadaun, Shekhar Singh
Das, Prasenjit
Shalimar,
Datta, Sudip K.
Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title_full Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title_fullStr Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title_full_unstemmed Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title_short Unusually Low Serum Alkaline Phosphatase Activity in a Patient with Acute on Chronic Liver Failure and Hemolysis
title_sort unusually low serum alkaline phosphatase activity in a patient with acute on chronic liver failure and hemolysis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416816/
https://www.ncbi.nlm.nih.gov/pubmed/30881280
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