A 12-year-old boy had blood taken during a work-up for recurrent abdominal pain, which has since settled witho…

Question

A 12-year-old boy had blood taken during a work-up for recurrent abdominal pain, which has since settled without treatment. He is well, is Tanner stage 3, and has grown 9 cm in the past year. He takes no medicines and there is no jaundice, hepatomegaly, bone pain or limb deformity. Results: alkaline phosphatase 480 U/L (adult reference 30 to 110), gamma-glutamyl transferase 18 U/L (5 to 50), alanine aminotransferase 24 U/L, bilirubin 9 micromol/L, with normal calcium and phosphate. Which one of…

Accepted Answer

No further investigation of the alkaline phosphatase

Answer

Arrange upper abdominal ultrasound

Answer

Measure 25-hydroxyvitamin D and parathyroid hormone

Answer

Refer to a paediatric gastroenterologist

Answer

Repeat liver function tests in six weeks

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