Do you see this patient frequently?

  • Recurrent bone pain or fractures
  • Short stature
  • Early loss of primary teeth (before age 5, without trauma)
  • Weakness or poor growth
  • Persistently low serum alkaline phosphatase

Do you see children with unexplained bone pain and early tooth loss?

Could hypophosphatasia be the underlying cause—and how can you help uncover it?

Adapted from reference: 1

Diagnosing HPP

ALP-based HPP calculator
  • When interpretating laboratory test results for the diagnosis of hypophosphatasia (HPP), it is important to determine the lower limits of alkaline phosphatase (ALP) using age- and sex-specific reference intervals (RIs).1
  • You can calculate ALP RIs for children and adolescents using the tool below, which includes five major analytical platforms - Abbott, Beckman, Ortho, Roche and Siemens, developed by the Canadian Laboratory Initiative in Pediatric Reference Intervals (CALIPER).1

Check ALP-based HPP
calculator

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Diagnosis of HPP is based on clinical and lab findings

Clinical Manifestations and PERSISTENTLY LOW AGE- AND SEX-ADJUSTED ALP Activity may confirm a diagnosis of HPP1,9

Early diagnosis of HPP is critical

Any sign/symptom in one or more of these systems
Dental
Growth/
Development
Muscular
Strength/Function
Skeletal
Renal
Neurologic
Respiratory
PERSISTENTLY LOW AGE- AND SEX-ADJUSTED ALP ACTIVITY HPP DIAGNOSIS

Adapted from references: 1-9

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References:

ALP, alkaline phosphatase (protein); HPP, hypophosphatasia.

  • Adeli K, et al. The Canadian laboratory initiative on pediatric reference intervals: A CALIPER white paper. Crit Rev Clin Lab Sci. 2017;54(6):358–413.
  • ARUP. Alkaline phosphatase isozymes, Serum or plasma. Available at: https://ltd.aruplab.com/Tests/Pub/0021020. Last accessed February 2024.
  • Colantonio DA, et al. Closing the gaps in pediatric laboratory reference intervals: a CALIPER database of 40 biochemical markers in a healthy and multiethnic population of children. Clin Chem. 2012;58:854–868.
  • Adeli K. Biochemical Marker Reference Values across Pediatric, Adult, and Geriatric Ages: Establishment of Robust Pediatric and Adult Reference Intervals on the Basis of the Canadian Health Measures Survey. Clin Chem. 2015;61(8):1049–1062.
  • Schumann G. IFCC primary reference procedures for the measurement of catalytic activity concentrations of enzymes at 37 °C. Part 9: Reference procedure for the measurement of catalytic concentration of alkaline phosphatase. Clin Chem Lab Med. 2011;49(9):1439–1446.
  • Quest Diagnostics. Alkaline phosphatase. Available at: https://testdirectory.questdiagnostics.com/test/test-detail/234/alkaline-phosphatase?cc=MASTER. Last accessed February 2024.
  • Labcorp. Alkaline phosphatase. Available at: https://www.labcorp.com/tests/001107/alkaline-phosphatase. Last accessed February 2024.
  • Bishop N. Transformative therapy in hypophosphatasia. Arch Dis Child. 2016;101(6):514–515.
  • Rockman-Greenberg C. Hypophosphatasia. Pediatr Endocrinol Rev. 2013;10(Suppl 2):380–388.