Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:3.1.3.1 (alkaline phosphatase)
47,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum osteocalcin (BGP), a vitamin K-dependent gamma-carboxyglutamic acid (GLA) containing bone protein, provides an index of bone turnover in patients with a variety of metabolic bone diseases. BGP increases with increasing age in both sexes, but more so in women. BGP rises above normal when the glomerular filtration rate falls below 30 ml/min. Because of its importance in bone disease, its low mol wt, and the effect of uremia, we measured BGP by RIA in serum and dialysate fluid in patients on hemodialysis (HD) or peritoneal dialysis (PD). In 32 HD patients (22 women and 10 men), serum BGP was not different pre- and postdialysis [67.5 +/- 4.4 (+/- SEM) ng/ml vs. 67.7 +/- 5.2), but was significantly elevated compared to the level in normal subjects (7.3 +/- 0.8 ng/ml). The sex difference previously reported in normal subjects was not found in patients with renal failure. The serum BGP level in 8 PD patients was 49.4 +/- 6.9 ng/ml, with a peritoneal fluid concentration of 27.6 +/- 9.3 ng/ml. The hemodialysate fluid concentration of BGP was 1.7 +/- 0.4 ng/ml, which was significantly lower than the serum BGP levels in the HD patients, the PD patients, and peritoneal fluid (P less than 0.01). A significant correlation existed among BGP, alkaline phosphatase, immunoreactive PTH, creatinine, and blood urea nitrogen. We conclude that BGP is markedly elevated in patients with renal failure, not altered in the serum by HD or PD, but very low in HD dialysate fluid. These findings may reflect a combination of impaired clearance and increased skeletal production. The difference in clearance between the peritoneal and hemodialysis fluid is compatible with the mol wt of BGP. In 15 patients who had successful kidney transplantation, serum BGP was normal despite an elevated serum PTH level.
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PMID:Serum and dialysate osteocalcin levels in hemodialysis and peritoneal dialysis patients and after renal transplantation. 388 31

In 42 uraemic patients radiological skeletal survey, biochemistry and bone histology were compared before and at 6-12 months (42 patients), 12-24 months (26 patients) or 24-48 months (12 patients) after parathyroidectomy. The presence of small vessel or non-visceral soft tissue calcification was not related to the age, sex, duration of end-stage renal failure treatment, total serum calcium, magnesium, phosphate, Ca x P product, alkaline phosphatase, ionised calcium, serum aluminium, iPTH, severity of radiological and histological osteitis fibrosa or parathyroid gland weight. Twenty-three patients (55%) had small vessel and 20 (48%) soft tissue calcification before parathyroidectomy. Despite a marked improvement in subperiosteal erosions (37 healed, 5 improved) and healing of osteitis fibrosa histologically, seven patients developed new and six developed increased peripheral arterial calcification while in 10 patients non-visceral soft tissue calcification disappeared and in two decreased. Successful parathyroidectomy improves non-visceral calcification but not arterial calcification despite reduction in Ca x P product and iPTH.
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PMID:Ectopic calcification. The role of parathyroid hormone. 399 87

The clinical syndrome of "shock liver," also known as ischemic hepatitis, is characterized by sudden elevation (to more than 20 times the upper limit of normal) of SGOT and SGPT in response to cellular anoxia, followed by resolution to near normal levels within seven to ten days. In our experience with ten cases, systemic hypotension was documented in only four, but processes characterized by decreased cellular perfusion were identified in all and included cardiac failure or arrhythmia, sepsis, cerebrovascular accidents, renal failure, and chronic obstructive pulmonary disease. We were also able to document the transient rise in serum bilirubin and alkaline phosphatase levels and prolonged prothrombin time that followed the transaminase elevations by 24 to 48 hours in most cases, followed by rapid resolution. In neither of the two cases in which tissue was available by biopsy after resolution of the biochemical abnormalities did we find the classic histologic picture of necrosis in zone 3 ("centrilobular necrosis"). The clinical picture of shock liver is so characteristic and resolves so rapidly that there should be no confusion with other causes of marked elevations of transaminase levels.
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PMID:Shock liver. 407 Nov 67

In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a peak incidence after about six months' treatment. In six of these patients hypercalcaemia was transient and the plasma calcium became normal with haemodialysis alone. In one patient the hypercalcaemia was persistent and the plasma calcium reverted to normal only after subtotal parathyroidectomy. This patient had no radiological bone disease, a normal alkaline phosphatase, and no metastatic calcification of the soft tissues.It is concluded that in some patients with terminal renal failure treated with maintenance haemodialysis autonomy of the parathyroids becomes evident in the absence of bone disease or a raised plasma alkaline phosphatase, and that subsequently with continued dialysis there is a spontaneous involution towards normal parathyroid function.
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PMID:Transient and persistent hypercalcaemia in patients treated by maintenance haemodialysis. 568 Oct 49

Six cases of severe leptospiral infection with renal failure are described. Five of the six patients had acute oliguric renal failure requiring dialysis. Renal function recovered over three weeks and by two months all patients had plasma creatinine levels less than 200 mumol/litre. The initial diagnosis of leptospirosis depended on clinical and epidemiological features because serological confirmation was not possible during the first week of the illness. All the patients had either high risk occupations or a history of exposure to external sources of infection. All had fever, myalgia, jaundice and muscle tenderness. Although bilirubin levels were high (greater than 350 mumol/litre in five) the elevations of aspartate transaminase and alkaline phosphatase levels, and prolongations of prothrombin times were relatively slight. Thrombocytopenia occurred in five of the six cases. Leptospira complement fixation tests were weakly positive or negative on admission in five cases but rose to significant levels subsequently. Penicillin treatment resulted in Jarisch-Herxheimer reactions in three cases. The important complications were: upper gastro-intestinal haemorrhage (five cases), thrombocytopenia less than 30 000 platelets/mm3 (four cases), atrial fibrillation (three cases), drowsiness with asterixis (four cases). All six patients were seriously ill and required intensive supportive therapy. All survived.
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PMID:Acute renal failure due to leptospirosis: clinical features and outcome in six cases. 633 67

An enzyme-linked immunosorbent technique for human serum retinol-binding protein (RBP) was developed. The assay detects RBP via a double-antibody (rabbit anti-human RBP) sandwich technique. The antibody is immobilized by passive adsorption to a polystyrene tube; the assay is then carried out by successive additions containing known and unknown amounts of RBP (antigen), alkaline phosphatase linked to the same antibody, and p-nitrophenyl phosphate (substrate). Colorimetric analysis of the hydrolysis of the substrate by the enzyme (indirectly) attached to the antigen is used for RBP quantitation. The intra- and interassay coefficients of variation ranged between 4 and 7 and 9 and 12%, respectively. The assay can be performed in less than 7 h and has a sensitivity in the nanogram range (3-48 ng/ml). RBP content was analyzed in serum and urine samples of 20 healthy donors and 17 patients with renal failure and in 20 serum specimens of patients with liver cirrhosis. Renal patients had higher serum (mean 150, range 50-398 micrograms/ml) and urine RBP levels (mean 14, range 1-80 micrograms/ml) than normal donors (mean serum 43, range 30-60 micrograms/ml; mean urine RBP 0.06, range 0.04-0.13 microgram/ml). Liver disease patients had lower than normal serum RBP values (mean 22, range 10-43 micrograms/ml).
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PMID:Quantitation of serum retinol-binding protein by an enzyme-linked immunosorbent assay. 635 83

A patient is presented with a postpartum hepatic artery thrombosis in association with presumed fibromuscular hyperplasia. Massive hepatic infarction developed characterized clinically by fever, coma, ascites, ileus, jaundice, and renal failure; and biochemically by markedly elevated SGOT and SGPT, alkaline phosphatase, total bilirubin levels, and decreased thromboplastin time. The diagnosis was made in vivo by computed tomography (CT). Angiography revealed thrombotic occlusion of the hepatic artery in association with presumed fibromuscular hyperplasia. Laparoscopy and biopsy confirmed the diagnosis.
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PMID:In vivo diagnosis of massive hepatic infarction by computed tomography. 646 35

The activity of intestinal isoenzyme of serum alkaline phosphatase was evaluated in 21 non-dialyzed patients with advanced renal failure and in 52 patients on regular hemodialysis. In patients without hepatopathy, a significant inverse correlation was found between the enzyme activity and serum calcium levels. Hepatopathy was the most significant variable influencing the enzyme activity in patients on dialysis. Secondary hyperparathyroidism and a decreased rate in enzyme elimination should be assessed for the above-normal activities of intestinal ALP in serum in chronic renal failure.
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PMID:Metabolic implications in the elevation of serum activity of intestinal alkaline phosphatase in chronic renal failure. 646 12

Biochemical and radiologic indices of bone disease were assessed in 26 insulin-dependent diabetic patients and 28 nondiabetic patients with endstage kidney disease. The two groups were comparable in age, sex, duration of renal failure, and length of time on dialysis. Diabetic patients showed significantly lower serum calcium and immunoreactive parathyroid hormone (iPTH) levels than nondiabetic patients. iPTH was not related to total serum calcium, but was positively correlated with serum phosphorous (r = 0.37, P less than 0.05 and r = 0.54, P less than 0.005, in nondiabetic and diabetic patients, respectively). iPTH correlated with alkaline phosphatase (r = 0.59, P less than 0.0009) and calcitonin (r = 0.51, P less than 0.05) only in nondiabetic patients. Osteitis fibrosa was noted radiologically in 30% of nondiabetic patients and in none of the diabetic patients (P less than 0.03). Bone morphology in eight diabetic patients who underwent iliac bone biopsy was characterized by reduced trabecular and osteoid bone volume, no woven bone, and marked reduction in indices of bone formation and resorption. The small amount of bone and lack of osteomalacia are a unique feature of the diabetic patient with chronic renal disease. The long-term sequelae of low bone turnover and reduced circulating iPTH may present a special problem to the long term diabetic survivor on the current therapies of uremia.
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PMID:Parathyroid and bone response of the diabetic patient to uremia. 648 71

Eighteen laboratory tests were compared in the differentiation of primary hyperparathyroidism from hypercalcemia associated with malignancy. Statistical comparisons of the test results were carried out in four patient groups and two control groups. The patient groups evaluated were those with confirmed primary hyperparathyroidism, those with malignancy with hypercalcemia, those with malignancy without hypercalcemia, and those with surgically cured primary hyperparathyroidism. These groups allowed determination of the relative diagnostic values of the tests and a rationale for their value. After exclusion of patients with renal failure from the patient and control groups, these data indicated that the laboratory tests with the greatest differential diagnostic value, in order of efficacy, were: albumin, carboxy-terminal parathyroid hormone, venous pH, cholesterol, chloride, alkaline phosphatase, phosphorus, and the chloride/phosphate ratio. Hemoglobin, hematocrit, and red blood cell count also had some value, particularly in male patients. However, none of these tests individually achieved better than an 81 percent classification accuracy. With application of logistic discriminant analysis, only three tests--albumin, parathyroid hormone, and chloride--were identified as statistically significant in jointly improving the diagnostic separation between these two patient groups. Although the 94.4 percent classification accuracy achieved by use of these three variables in a logistic discriminant function was better than that obtained with any individual variable, incorrect classification was still a significant problem, particularly in the case of patients with malignancy and high concentrations of parathyroid hormone. With the exception of albumin and chloride measurements, the commonly available ancillary laboratory tests proposed to aid this differential diagnosis do not give any more information than the analysis of parathyroid hormone alone and merely add to the increased cost of medical care.
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PMID:Value of laboratory tests in the differential diagnosis of hypercalcemia. 649 41


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