You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is Alkaline phosphatase is elevated in all except: and explain in detail?
Ans. D: Pernicious anemia Normal physiologic elevation - Age: increased values in first 3 months of life and at pubey, normal values in women by 18 years in men by 20 years. - Sex: between age 20 and 50 years men are 20% higher than women, after menopause women are higher - Hormonal status: increased values in pubey, pregnancy (placental isoenzyme), and postmenopause - Blood type: type 0 and B associated with elevation in intestinal isoenzyme, type AB with intermediate values - Factors Associated with Elevation: Tobacco use, increased blood sugars, increasing weight, decreasing height. Pathologic elevation Hepatobiliary disease: biliary obstruction due to stones, stricture, tumor; Autoimmune: primary biliary cirrhosis, sclerosing cholangitis; infiltrative granulomatous hepatitis, fatty liver, amyloidosis, sarcoidosis, malignancy; medications: estrogen, chlorpromazine, erythromycin; viral hepatitis Bone disease: Paget disease, osteomalacia, hyperparathyroidism, metastatic bone disease, Vitamin D deficiency, recent trauma or fracture. Other causes: resolution phase of myocardial infarction, pulmonary, renal, gastrointestinal, or splenic infarction; ulceration in gastrointestinal tract; congestive hea failure with hepatic congestion; autosomal dominant familial inheritance; transient hyperphosphatemia of infancy; bronchogenic, breast, colon, ovarian, cervical, or prostate cancer; metastatic carcinoma to pleural surfaces