Hypophosphatasia (HPP) is a metabolic disorder characterized by LOW Alkaline Phosphatase (ALP) activity1 Patients with HPP may experience unpredictable, devastating, and life-limiting consequences, including:1 SHORT STATURE AND/OR UNUSUAL GAIT PREMATURE TOOTH LOSS MUSCLE WEAKNESS AND/OR FATIGUE • In adults, low ALP activity is <40 U/L2,a CHRONIC MUSCLE/ JOINT PAIN SKELETAL DEFORMITIES AND/ OR FRACTURES • Age- and sex-adjusted ALP reference intervals must be used in children3.4 Patients with any of these key signs/symptoms and LOW ALP should be evaluated for HPP1 a Example cutoff from Abbott Laboratories; adult ALP ranges are lab specific and may vary. References: 1. Bishop N, et al. Arch Dis Child. 2016;101(6):514-515. 2. Alkaline phosphatase [package insert]. Abbott Park, IL: Abbott Laboratories; 2007. 3. Offiah AC, et al. Pediatr Radiol. 2019;49(1):3-22. 4. Colantonio DA, et al. Clin Chem. 2012;58(5):854-868. LOW Alkaline Phosphatase (ALP) may not be flagged if your laboratory does not use age- and sex-adjusted reference intervals in children when testing ALP activity1 Age- and sex-adjusted ALP reference ranges, U/L2,3 Females 518 518 400 100 280 273 90 369 156 141 134 128 62 365 273 54 95 48 014 15 d d<1 y 1<1 0 10 y -<1 3 13 y -<1 5 15 y -<1 7 17 y -<1 9 y 0 460 369 300 200 517 460 90 Normal ALP 156 141 134 127 164 89 59 014 15 d d<1 y 1<1 0 10 y -<1 3 13 y -<1 5 15 y -<1 7 17 y -<1 9 y ALP Activity, U/L 500 Males 150 40 Low ALP in pediatric females Low ALP in pediatric males Low ALP in adults Ad ult sa 600 Age NOTE: Graph adapted from the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) project. 2 Caliper samples from 1072 male and 1116 female participants (newborn to 18 years) were used to calculate age- and sex-specific reference intervals. No variation in ALP based on ethnic differences was observed. Reference intervals shown were established on the Abbott ARCHITECT c8000 analyzer. a Adult interval provided by the Abbott ARCHITECT ALP product information sheet is for females >15 and males >20 years of age. For younger ages, Abbott does not provide lower limits of normal.3 LOW Alkaline Phosphatase (ALP) is hallmark of Hypophosphatasia.1 To learn more, please visit www.hypophosphatasia.com References: 1. Rockman-Greenberg C. Pediatr Endocrinol Rev. 2013;10(2 suppl):380-388. 2. Colantonio DA, et al. Clin Chem. 2012;58(5):854-868. 3. Alkaline phosphatase [package insert]. Abbott Park, IL: Abbott Laboratories; 2007. Please contact [amy.flinn@alexion.com] to learn more information about hypophosphatasia. Alexion is a registered trademark of Alexion Pharmaceuticals, Inc. Copyright © 2020, Alexion Pharmaceuticals, Inc. All rights reserved. MO-AFP.ORG 7 US/UNB-H/0095