Bone diseases causing asymptomatic elevation of ALP

The common diseases which may cause asymptomatic chronic elevation of alkaline phosphatase include:

• Paget's disease
• osteomalacia (vitamin D deficiency)

Note that vitamin D insufficiency may also be associated with an asymptomatic raised alkaline phosphatase level.

• vitamin D deficiency
  • profiles of serum calcium, phosphate and alkaline phosphatase may sometimes be helpful in the diagnosis of vitamin D deficiency
    • note though that serum calcium and phosphate concentrations only fall in longstanding, symptomatic, vitamin D deficiency; there is an increase in levels of alkaline phosphatase (total and bone-specific) increase early in vitamin D deficiency
      • this is a non-specific finding, but may be helpful in diagnosing individuals with otherwise unexplained elevations in alkaline phosphatase