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September 1972

Increase in Serum Alkaline Phosphatase Due to Regan Isoenzyme in a Patient With Localized Jejunal Lymphoma

Author Affiliations

From the Department of Medicine, Lemuel Shattuck Hospital and Tufts University Medical School (Dr. Stolbach) and the departments of surgery (Dr. Skillman) and medicine (Dr. Goodman), Beth Israel Hospital and Harvard Medical School, Boston.

Arch Surg. 1972;105(3):491-493. doi:10.1001/archsurg.1972.04180090094022

An elevation of the serum alkaline phosphatase level was found in a patient following resection of a localized jejunal lymphoma. The elevation was due to the presence of Regan isoenzyme of alkaline phosphatase and is assumed to have been produced by the tumor. Following resection of the tumor there was an exponential drop in the level of Regan isoenzyme to undetectable levels 3½ months after surgery. The half-life of the alkaline phosphatase isoenzyme in this case was calculated as ten days. The patient has not shown any recurrence of tumor and the Regan isoenzyme remains undetectable two years after his surgery. This case demonstrates that the finding of an elevated alkaline phosphatase level in a patient with malignancy does not necessarily indicate metastatic disease to bone or liver and should not exclude curative surgery.

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