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Why can alkaline phosphatase levels be high in Paget disease of bone?
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bone disease
Defect of tibia, caused by septic osteomyelitis in childhood, with compensatory thickening of the fibula (right). Normal bones are shown at left.
In Paget disease of bone, alkaline phosphatase levels are often elevated due to the disease's characteristic cycle of excessive bone remodeling.1
The condition involves highly active osteoclasts that rapidly resorb bone tissue, which in turn triggers a compensatory increase in bone formation by local osteoblasts. Because alkaline phosphatase is an enzyme essential for the deposition of minerals during the bone-building process, the body produces it in higher concentrations to support this intense, disorganized, and excessive formation of new bone tissue. Consequently, high serum concentrations of this enzyme serve as a clinical indicator of the increased osteoblastic activity occurring within the affected bones.12