Bone-specific Alkaline Phosphatase (BAP)

CPT: 84080
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Test Details

Synonyms

  • BAP
  • Ostase®
  • Skeletal Alkaline Phosphatase (SALP)

Use

Quantitative measurement of skeletal alkaline phosphatase to be used as an aid in the management of patients with Paget disease and osteoporosis

Limitations

Serum specimens with significant elevations of liver alkaline phosphatase may cause aberrantly elevated results with the Ostase® assay.

Methodology

Immunochemiluminometric assay (ICMA)

Contraindications

Patients who have undergone therapy that includes infusion with mouse monoclonal antibody may produce erroneous results.

Reference Interval

Reference interval change (November 2015)1-3

Age

Male (μg/L)

Female (μg/L)

0 to 5 m

Not established

Not established

6 to 11 m

48.2−170.2

50.4−154.0

1 y

41.9−229.6

44.2−178.3

2 y

41.7−139.4

34.9−195.4

3 to 4 y

37.2−127.7

37.4−96.8

5 to 6 y

42.0−104.2

31.4−100.8

7 to 8 y

59.0−101.3

44.0−135.8

9 to 10 y

50.4−133.0

47.9−150.8

11 to 12 y

53.3−156.8

24.2−133.3

13 to 14 y

77.5−169.8

19.8−92.7

15 to 16 y

26.8−173.4

11.2−30.2

17 to 18 y

15.4−69.8

8.8−29.0

19 to 20 y

12.2−36.6

7.7−16.8

21 to 29 y

7.4−27.7

See below

30 to 34 y

7.0−27.4

See below

35 to 39 y

4.0−27.0

See below

40 to 44 y

7.4−26.7

See below

45 to 49 y

7.5−26.4

See below

50 to 54 y

7.5−26.1

See below

55 to 59 y

7.5−25.7

See below

60 to 64 y

7.5−25.4

See below

65 to 69 y

7.6−25.1

See below

70 to 74 y

7.6−24.8

See below

75 to 100 y

7.6−24.4

See below

Female

Premenopausal: 6.0−22.7 μg/L

Postmenopausal: 8.1−31.6 μg/L

Specimen Requirements

Specimen

Serum

Volume

1 mL

Minimum Volume

0.5 mL

Container

Gel-barrier tube or transport tube

Collection

Separate serum from cells within 45 minutes of collection. If a red-top tube is used, transfer separated serum to a plastic transport tube.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Gross hemolysis; quantity not sufficient for analysis

Clinical Information

Footnotes

1. Wyness SP, Roberts WL, Straseski JA. Pediatric reference intervals for four serum bone markers using two automated immunoassays. Clin Chim Acta. 2013 Jan 16; 415:169-172. 23122966
2. Cavalier E, Delanaye P. Analytical performance of a new bone-specific ALP automated immunoassay. J Am Soc Nephrol 24. 2013:754A.
3. Michelsen J, Wallaschofski H, Friedrich N, et al. Reference intervals for serum concentrations of three bone turnover markers for men and women. Bone. 2013 Dec; 57(2):399-404. 24076251

References

Delmas PD. Biochemical markers of bone turnover: Methodology and clinical use in osteoporosis. Am J Med. 1991; 91(5B):59S-63S. 1750421
van Straalen JP, Sanders E, Prummel MF, et al. Bone-alkaline phosphatase as indicator of bone formation. Clin Chim Acta. 1991; 201(1-2):27-33. 1790624

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