Isoenzymes of alkaline phosphatase in diagnostics of intrahepatic cholestasis of pregnancy

Česká verzia

Authors: L. Turecký; Ľ. Divéky; V. Kupčová
Authors place of work: Ústav lekárskej chémie, biochémie a klinickej biochémie LFUK ¹; III. interná klinika LFUK ²; II. gynekologicko-pôrodnícka klinika LFUK Bratislava ³; Alpha medical a. s. – Inštitút laboratórnej diagnostiky, Ružomberok ⁴
Published in the journal: Prakt Gyn 2008; 12(2): 104-107

Práce je převzata z časopisu Praktická gynekológia 2007; 14 (2): 41–45 na základě spolupráce redakcí našich časopisů a dohody o výměně odborných prací.

Summary

Intrahepatic cholestasis of pregnancy (ICP) is a reversible form of cholestasis in late pregnancy, persisting until delivery. Compared to healthy pregnancies, total serum alkaline phosphatase (ALP) levels are usualy more elevated in patients with ICP but are of poor diagnostic value. One of the reasons for poor diagnostic value of ALP determination in this complication of pregnancy is physiological elevation of ALP activity during pregnancy due to placental ALP isoenzyme. In our study we analysed the possibility of determination od ALP isoenzyme activities in patients with ICP. The results of this study showed, that determination of ALP isoenzymes in patients with this type of pregnancy complication increases the sensitivity of ALP determination (69 % positive results of ALP isoenzyme determination vs. 46% positive results of total ALP determination) (Tab. 2, Fig. 4 [9]).

Key words:
intrahepatic cholestasis of pregnancy, alkaline phosphatase, isoenzymes of alkaline phosphatase, serum bile acids.

Zdroje

1. Lammert F, Marschall HU, Glantz A, Matern S. Intrahepatic cholestasis of pregnancy: molecular pathogenesis, diagnosis and management. J Hepatol 2000; 33: 1012–1021.

2. Rioseco AJ, Ivankovic MB, Manzur A et al. Intrahepatic cholestasis of pregnancy: a retrospective case-control study of perinatal outcome. Am J Obstet Gynecol 1994; 170: 890–895.

3. Alsulyman OM, Ouzounian JG, Ames-Castro M, Goodwin TM. Intrahepatic cholestasis of pregnancy: perinatal outcome associated with expectant management. Am J Obstet Gynecol 1996; 175: 957–960.

4. Walker IA, Nelson-Piercy C, Williamson C. Role of bile acid measurement in pregnancy. Ann Clin Biochem 2002; 39: 105–113.

5. Turecký L, Kupčová V, Szantová M et al. Význam vyšetrovania plazmatickej koncentrácie žlčových kyselín u žien s intrahepatálnou cholestázou gravidných. Prakt Gynek 2005; 12: 56–60.

6. Thomas L. Alkalische phosphatase. In: Thomas L. (ed.): Labor und Diagnose. Frankfurt/ Main: TH-Books Verlagsgesellschaft mbH 2000: 37–47.

7. Smith M, Weiss MJ, Griffi n CA et al. Regional assignment of the gene for human liver/bone/ kidney alkaline phosphatase to chromosome 1p36.1–p34. Genomics 1988; 2: 1399–1443.

8. Holmgren FA, Sigbrant T, Dambnert MG, von Schoultz B. Serum levels of placental alkaline phosphatase in high – risk pregrancies. Obstet Gynecol 1979; 54: 631–634.

9. Dixon PH, Weerasekera N, Linton KJ et al. Heterozygous MDR3 missense mutation associated with intrahepatic cholestasis of pregnancy: evidence for a defect in protein traffi cking. Hum Mol Genet 2000; 9: 1209–1217.