Serum alkaline phosphate is not rased in -

ALKALINE PHOSPHATASE. Serum alkaline phosphataseis produced by many tissues, especially bone, liver,intestine and placenta and is excreted in the bile. Most of thenormal serum alkaline phosphatase (range 33-96 U/L) isderived from bone. Elevation in the activity of the enzyme canthus be found in diseases of the bone, liver and in pregnancy. Inthe absence of bone disease and pregnancy, an elevatedserum alkaline phosphatase levels generally reflecthepatobiliary disease. The greatest elevation (3 to 10 timesnormal) occurs in biliary tract obstruction. Slight to moderateincrease is seen in parenchymal liver diseases such as inhepatitis and cirrhosis and in metastatic liver disease. It ispossible to distinguish serum hepatic alkaline phosphatasefrom bony alkaline phosphatase by fractionation intoisoenzymes but this is not routinely done. ALP increases in multiple myeloma only when associated with fractures HARSH MOHAN Textbook of pathology 6th edition pg no 595