A 61-year-old man presented with lumbosciatic pain radiating to the left lower limb.
Her past medical history included urolithiasis and herniorrhaphy.
Physical examination was normal.
Complete blood count and biochemistry were normal except for alkaline phosphatase (ALP) total of 690 IU/l (normal range: 40-129 IU/l).
These values were confirmed in a second sample and in the study of isoenzymes of AF by electrophoresis it was determined that the enzymes corresponded to: 50% intestinal FA, 33% bone FA and 17% hepatic FA.
X-rays showed signs of irregular heart beat without other abnormalities.
A bone scan was normal in the radioisotope distribution.
Magnetic resonance imaging of the lumbar spine revealed changes in spondyloarthrosis and L4-L5 disc disease.
One year later the same high values of total serum AF persisted.
Then the relatives were evaluated, the three children of the patient were studied, the results showed that in a 32-year-old son of the patient, also presented an increase in total serum AF, being totally asymptomatic.
In this case, the increase was milder, 171 IU/l but the study of isenzymes showed 50% intestinal AF.
There were no alterations in the bone scintigraphy performed or in the rest of the biochemical measurements, which included liver enzymes and bone balance.
