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ARTICLE TYPE : LETTER TO EDITOR

Published on :   14 Oct 2026, Volume - 2
Journal Title :   WebLog Journal of Hepatology | WebLog J Hepatol | WJHP
Source URL:   weblog icon https://weblogoa.com/articles/wjhp.2026.j1404
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.23342966

Infantile Benign Transient Hyperphosphatasemia Presenting as an Isolated Extreme ALP Elevation in a Toddler Undergoing Preoperative Evaluation

Khatri LK 1
More AB 2
Govani PS 3
Patel RV 4 *
1Honorable Clinical Fellow, Department of Cardiothoracic Surgery, Guys and St Thomas’ NHS Foundation Trust, London, United Kingdom
2Department of Pediatric Surgery, Southampton General Hospital, Southampton, United Kingdom
3RMO, Rajkot Cancer Hospital, Rajkot, Gujarat, India
4Department of Pediatric Surgery, PGICHR and KTCGUH, Rajkot, Gujarat, India

Abstract

Benign Transient Hyperphosphatasemia (BTH) is a self-limiting biochemical condition characterized by marked elevation of serum Alkaline Phosphatase (ALP) in otherwise healthy infants and young children. We report a 14-month-old girl undergoing preoperative evaluation for anorectal malformation who was incidentally found to have an isolated ALP elevation of 2277 U/L. Comprehensive evaluation, including liver function tests, gamma-glutamyl transferase, renal profile, calcium, phosphate, vitamin D levels, and abdominal imaging, revealed no evidence of hepatobiliary, metabolic, renal, or skeletal disease. The child remained clinically well, and repeat testing four months later demonstrated complete normalization of ALP levels, confirming the diagnosis of BTH. Recognition of this benign and transient condition is important to avoid unnecessary investigations, specialist referrals, parental anxiety, and healthcare expenditure. Clinicians should consider BTH in infants and toddlers presenting with isolated extreme ALP elevation in the setting of otherwise normal clinical and biochemical findings.

Keywords: Benign Transient Hyperphosphatasemia; Alkaline Phosphatase; Infancy; Toddler; Hepatology; Incidental Finding

Citation

Khatri LK, More AB, Govani PS, Patel RV. Infantile Benign Transient Hyperphosphatasemia Presenting as an Isolated Extreme ALP Elevation in a Toddler Undergoing Preoperative Evaluation. WebLog J Hepatol. wjhp.2026.j1404. https://doi.org/10.5281/zenodo.23342966
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