High Alkaline Phosphatase in Chronic Non-cholestatic Hepatitis

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Abstract
Follow-ups of 4 cases of chronic hepatitis are presented, in whom the serum alkaline phosphatase activity was increased 3 to 9 times more than the upper normal limit. Evidence for an intrahepatic cholestasis was not found. Cholesterol and bilirubin levels in the sera were normal. The bile ducts were visible radiologically in 3 of the 4 cases. No histologic evidence was found for an alteration of the bile ducts. In 3 cases the alkaline phosphatase activity decreased, becoming normal along with the transaminases and remission of the histologically verified inflammation in two studied cases. Evidence for the hepatic origin of alkaline phosphatase in the sera of patients with liver diseases was discussed. In liver diseases with high activity of alkaline phosphatase in the serum without hyperbilirubinemia not only liver metastases and early stages of primary biliary cirrhosis must be considered but also non-cholestatic chronic hepatitis.

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