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Fosfatasas alcalinas

, : Fosfatasas alcalinas. EMC - Tratado de Medicina 17(1): 1-5

Son isoenzimas de membrana con funciones poco conocidas. Existen en la mayor a de los tejidos. Su concentraci n s rica refleja principalmente la actividad de las isoenzimas hep tica y sea. Las fosfatasas alcalinas aumentan de manera fisiol gica durante el tercer trimestre del embarazo y por efecto del crecimiento seo (per odo neonatal y adolescencia). La elevaci n de las fosfatasas alcalinas asociada a la de las gamma glutamil transpeptidasas indica la existencia de un trastorno hep tico. La mayor a de las enfermedades del h gado (hepatitis viral o autoinmune, cirrosis, cirrosis biliar primaria, tumor, granulomatosis, etc.) y de las v as biliares producen una elevaci n de las fosfatasas alcalinas. Se ha de descartar una obstrucci n de la v a biliar principal por litiasis o c ncer. El aumento aislado de las fosfatasas alcalinas es sospechoso de compromiso seo. Cuando se observan modificaciones de la remodelaci n sea (formaci n y resorci n de hueso) hay que buscar los siguientes cuadros: enfermedad de Paget sea, met stasis seas (c nceres de mama, pr stata, pulm n), hiperparatiroidismo, osteomalacia y fractura o aplastamiento vertebral reciente. As pues, las fosfatasas alcalinas pueden experimentar una elevaci n fisiol gica, principalmente por crecimiento o embarazo, o bien una elevaci n patol gica, que obliga a investigar, de entrada, una posible enfermedad hep tica u sea.


DOI: 10.1016/S1636-5410(12)64063-X

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