Marked elevation (≥4 times the upper limit of normal)* | Extrahepatic biliary obstruction¶ |
Choledocholithiasis (most common)
| |
Malignant obstruction
| |
Biliary strictures
| |
Infections
| |
Intrahepatic cholestasis | |
Drug and toxins associated with cholestasisΔ | |
Primary biliary cholangitisΔ | |
Primary sclerosing cholangitisΔ | |
Intrahepatic cholestasis of pregnancy | |
Benign postoperative cholestasis | |
Total parenteral nutrition | |
Infiltrative diseasesΔ
| |
Metastatic carcinoma to the liverΔ | |
Liver allograft rejection | |
Other cholangiopathies (eg, IgG4 cholangiopathy, ischemic cholangiopathy, COVID-19) | |
Alcohol-associated hepatitis | |
Sickle cell disease (hepatic crisis) | |
Nonhepatic causes◊ | |
Transient hyperphosphatemia of infancy and childhood | |
Moderate elevation (<4 times upper limit normal) | Hepatic causes |
Nonspecific, seen with all types of liver disease including:
| |
Nonhepatic causes◊ | |
Physiologic (children and adolescents) | |
Third trimester of pregnancy | |
Influx of intestinal alkaline phosphatase after eating a fatty meal (individuals with blood type O or B) | |
High bone turnover
| |
Extrahepatic disease
|
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