Cyanocobalamin-Dependent Depression of the Serum Alkaline Phosphatase Level in Patients with Pernicious Anemia

Abstract
LOWERING of the serum alkaline phosphatase activity has received little attention.1 It is known in scurvy and hypophosphatasemia and after exposure to radioactive substances that are deposited in bone. In children the serum alkaline phosphatase falls to adult levels when the skeletal growth is disturbed (as in achondroplasia or cretinism).2 We observed a patient suffering from both pernicious anemia and Paget's disease. The serum phosphatase level was normal and increased to abnormal height only after administration of vitamin B12.One possible explanation of these facts was that osteoblastic activity had been depressed by vitamin B12 deficiency. If . . .