Izoenzimi alkalne fosfataze u djece s respiracijskim bolestima

Cilj: Prikazati elektroforetsku sliku izoenzima ALP u serumu dojenčadi i djece koja su u tijeku akutne respiracijske bolesti imala povećanu ukupnu katalitičku aktivnost ALP. Ispitanici i metode: Prikazani su rezultati u 21 djeteta (od toga 17 dojenčadi), 8 djevojčica i 13 dječaka, u dobi od 2 mjeseca do 8 godina, hospitaliziranih zbog respiracijskih bolesti. U serumu djece određena je ukupna katalitička aktivnost ALP i provedeno elektroforetsko razdvajanje izoenzima ALP. Rezultati: Osmoro djece (38,1%) je u tijeku hospitalizacije imalo povećanu ukupnu katalitičku aktivnost ALP (raspon od 528 do 5622 U/L). Tipičnu sliku benigne prolazne hiperfosfatazemije, koja podrazumijeva pojavu brze anodne frakcije (brža od jetrene frakcije) i tzv. katodne frakcije (brža od koštane frakcije), imalo je petero djece. Izoenzim nalik placentalnom izoenzimu izdvojio se u dvoje djece. Izraženu koštanu frakciju, ali i frakciju nalik placentalnoj imalo je dijete s rahitisom. Predjetreni oblik ALP otkriven je kod dvoje djece, a jetreni izoenzim u jednog djeteta. Zaključak: Akutna respiracijska bolest u dojenčadi i djece može imati za posljedicu prolazno povećanje katalitičke aktivnosti ALP odnosno pojavu različitih izoenzimskih vrpca, primjerice brze anodne i tzv. katodne frakcije (kod prolazne hiperfosfatazemije), predjetrene frakcije i frakcije koja odgovara placentalnom izoenzimu. Prolazna hiperfosfatazemija se dokazuje nakon što se ukupna aktivnost ALP značajno smanji odnosno vrati u referentne raspone unutar 3-4 mjeseca. U tom slučaju daljnje analize nisu potrebne.
Aim: To present the electrophoretic pattern of alkaline phosphatase (ALP) isoenzymes in serum of infants and children exhibiting increased total ALP catalytic activity in the course of acute respiratory disease. Subjects and methods: Results obtained in 21 children (17 of them infants), including 13 male and eight female children aged 2 months to 8 years, hospitalized for respiratory diseases are presented. Total ALP catalytic activity was determined and electrophoretic separation of ALP isoenzymes was performed in children's sera. Results: Increased total ALP catalytic activity (range, 528-5622 U/L) during hospital stay was recorded in eight (38.1%) children. A typical picture of be-nign transient hyperphosphatasemia (TH), which implies the occurrence of fast anodal fraction (faster than hepatic fraction) and near-cathode fraction (faster than bone fraction), was recorded in five children. The placental-like isoenzyme was detected in two children. Expression of bone fraction and placental-like fraction was recorded in a rachitic child. Prehepatic ALP was expressed in two children, and hepatic ALP isoenzyme in one child. Conclusion: Acute respiratory disease in infants and children may entail transient increase in the ALP catalytic activity with the occurrence of various isoenzyme bands such as fast anodal and near-cathode fraction (in TH), prehepatic fraction and placental-like fraction. TH is verified when total ALP activity has decreased and returned to reference intervals. In this case, no additional testing is required.