Pediatric reference intervals for alkaline phosphatase

Zierk J, Arzideh F, Haeckel R, Cario H, Fruehwald MC, Gross HJ, Gscheidmeier T, Hoffmann R, Krebs A, Lichtinghagen R, Neumann M, Ruf HG, Steigerwald U, Streichert T, Rascher W, Metzler M, Rauh M (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Clinical Chemistry and Laboratory Medicine Walter de Gruyter

Book Volume: 55

Pages Range: 102-110

Journal Issue: 1

DOI: 10.1515/cclm-2016-0318

Abstract

BACKGROUND: Interpretation of alkaline phosphatase activity in children is challenging due to extensive changes with growth and puberty leading to distinct sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics and seem reasonable for an analyte as closely linked to growth as alkaline phosphatase. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, resulting in limitations when clinical decisions are based on alkaline phosphatase activity. METHODS: We applied an indirect method to generate percentile charts for alkaline phosphatase activity using clinical laboratory data collected during the clinical care of patients. A total of 361,405 samples from 124,440 patients from six German tertiary care centers and one German laboratory service provider measured between January 2004 and June 2015 were analyzed. Measurement of alkaline phosphatase activity was performed on Roche Cobas analyzers using the IFCC's photometric method. RESULTS: We created percentile charts for alkaline phosphatase activity in girls and boys from birth to 18 years which can be used as reference intervals. Additionally, data tables of age- and sex-specific percentile values allow the incorporation of these results into laboratory information systems. CONCLUSIONS: The percentile charts provided enable the appropriate differential diagnosis of changes in alkaline phosphatase activity due to disease and changes due to physiological development. After local validation, integration of the provided percentile charts into result reporting facilitates precise assessment of alkaline phosphatase dynamics in pediatrics.

Authors with CRIS profile

Jakob Zierk Department of Paediatrics and Adolescent Medicine Wolfgang Rascher Department of Paediatrics and Adolescent Medicine Markus Metzler Professur für Kinder- und Jugendmedizin mit dem Schwerpunkt Pädiatrische Onkologie und Hämatologie Manfred Rauh Department of Paediatrics and Adolescent Medicine

Involved external institutions

Universitätsklinikum Heidelberg DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Klinikum Augsburg DE Germany (DE) MVZ Labor PD Dr. Volkmann und Kollegen DE Germany (DE) Klinikverbund Bremen (Gesundheit Nord) DE Germany (DE) Universität Bremen DE Germany (DE) Universitätsklinikum Würzburg DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE)

How to cite

APA:

Zierk, J., Arzideh, F., Haeckel, R., Cario, H., Fruehwald, M.C., Gross, H.-J.,... Rauh, M. (2017). Pediatric reference intervals for alkaline phosphatase. Clinical Chemistry and Laboratory Medicine, 55(1), 102-110. https://dx.doi.org/10.1515/cclm-2016-0318

MLA:

Zierk, Jakob, et al. "Pediatric reference intervals for alkaline phosphatase." Clinical Chemistry and Laboratory Medicine 55.1 (2017): 102-110.

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