Bone Alkaline Phosphatase (Sendout)

General Information

Lab Name
Bone Alkaline Phosphatase
Lab Code
RBAPG
Epic Name
Bone Alkaline Phosphatase (Sendout)
External Test Id
BAP
Description

Useful For:

  • Diagnosis and assessment of severity of metabolic bone disease including Paget disease, osteomalacia, and other states of high bone turnover.
  • Monitoring efficacy of antiresorptive therapies including postmenopausal osteoporosis treatment.

Note: The assay is not intended as a screening test for osteoporosis. Measurements of bone turnover markers are not useful for the diagnosis of osteoporosis; diagnosis of osteoporosis should be made on the basis of bone density.

References
  1. Mayo Clinic Laboratories Bone Alkaline Phosphatase Clinical & Interpretive Information
Synonyms
BAP, Bone Specific Alkaline Phosphatase, BSAP, Skeletal Alkaline Phosphatase
Components

Interpretation

Method

Immunoenzymatic Assay

Reference Range
See individual components
Ref. Range Notes

Interpretation:

Bone alkaline phosphatase (BAP) concentration is high in Paget disease and osteomalacia.¹

Antiresorptive therapies lower BAP from baseline measurements in Paget disease, osteomalacia, and osteoporosis. Several studies have shown that antiresorptive therapies for management of osteoporosis patients should result in at least a 25% decrease in BAP within 3 to 6 months of initiating therapy.¹ BAP also decreases following antiresorptive therapy in Paget disease.¹

When used as a marker for monitoring purposes, it is important to determine the critical difference (or least significant change). The critical difference is defined as the difference between 2 determinations that may be considered to have clinical significance. The critical difference for this method was calculated to be 25% with a 95% confidence level.¹

Interferences and Limitations

Cautions:

Assay results should only be used in conjunction with information available from the clinical evaluation of the patient and other diagnostic procedures.

Human antimouse or other heterophile antibodies may be present in patient specimens. Although the assay has been specifically formulated to minimize their effects on the assay, results from patients known to have these antibodies should be carefully evaluated.

Liver-derived alkaline phosphatase (ALP) has some cross-reactivity in this assay: 100 U/L of liver ALP activity gives a result of 2.5 mcg/L to 5.8 mcg/L. Accordingly, serum specimens with significant elevations of liver ALP activity may yield elevated results.

References
  1. Mayo Clinic Laboratories Bone Alkaline Phosphatase Clinical & Interpretive Information

Ordering & Collection

Specimen Type
Blood
Collection

3 mL blood in GOLD SST or RED TOP tube

Handling Instructions

Outside Laboratories: Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Stability: Refrigerated (preferred): 14 days; Frozen: 90 days; Ambient: 7 days.

Reject Due To: Gross hemolysis. Gross lipemia is acceptable.

Quantity
Requested: 0.6 mL serum
Minimum: 0.5 mL serum

Processing

Receiving Instructions

Centrifuge sample and transfer serum to a separate plastic vial. Refrigerate serum.

Sendouts:

  • Order Mayo Test: BAP.
  • Interfaced: Yes.

Stability: Refrigerated (preferred): 14 days; Frozen: 90 days; Ambient: 7 days.

Reject Due To: Gross hemolysis. Gross lipemia is acceptable.

Misc Sendout

Performance

Lab Department
Sendouts Mayo Lab (RF)(MARF)
Frequency
Performed: Monday - Saturday. Report Available: 2-3 days.
Available STAT?
No
Performing Location(s)
Sendout Mayo Clinic Laboratories (Superior Drive)
800-533-1710

3050 Superior Drive NW
Rochester, MN 55901

Billing & Coding

CPT Codes
84080
LOINC
17838-4
Interfaced Order Code
UOW5139