ESPN 50th Annual Meeting

ESPN 2017


 
Transient hyperphosphatasemia after renal transplantation in 2 children
DIMITAR ROUSSINOV 1 POLINA MITEVA 1

1- UNIVERSITY PEDIATRIC HOSPITAL, MEDICAL UNIVERSITY, SOFIA
 
Introduction:

Transient, isolated hyperphosphatasemia has been rarely reported in pediatric and adult transplant patients.

Material and methods:

We describe two cases in boys after living donor kidney transplantation (Tx).

Results:

They were 7 and 9 years old respectively in good general condition, without clinical problems, on immunosuppression with tacrolimus and mofetil mycophenolate with stable blood levels and doses. In the first case, 10 months after Tx increased level of serum alkaline phosphatase (AP) was noticed on regular blood check. All other blood tests, enzymes, PTH and bone markers were within normal range as well as no data for infection. Bone izoenzyme of AP was elevated. It peaked at 4868 U/l 1 month later and went down to normal values after 3 months. In the second case, 7 months after Tx increased level of AP was registered on regular blood check. All other blood tests, enzymes, PTH and bone markers were within normal range as well as no data for infection. Liver izoenzyme of AP was elevated. It peaked at 6284 U/l 1,5 months later and went down to normal values after 3 months. However, 10 days latter CMV infection, presenting as pneumonia was detected by PCR and treated accordingly.

Conclusions:

Transient, isolated hyperphosphatasemia could be seen in children after renal Tx and is benign condition, which resolves without treatment. However, it might precede some infections.