TRANSIENT HYPERPHOSPHATASEMIA IN CHILDREN TREATED WITH GRISEOFULVIN

Abstract

CASE
The hallmark of transient hyperphosphatasemia (TH) is an elevation of serum alkaline phosphatase (ALP), which resolves within a few weeks or months without evidence of liver or bone disease. Despite its unknown etiology, it is frequently found in children under the age of five following an acute viral infection. We report a 7-year-old male who developed TH after receiving griseofulvin treatment for tinea capitis. He complained of fever and generalized erythematous rashes two weeks after treatment. Because of a possible drug allergy, blood tests were evaluated. Liver function showed normal transaminase and bilirubin levels, but the ALP was extremely high (2,657 IU/L). His serum calcium, phosphorus, PTH, and vitamin D were normal. Griseofulvin or viral exanthem were suspected of causing hyperphosphatasemia. Because his scalp lesion was worsening, itraconazole was substituted. After two months of monitoring, his ALP returned to normal. As a result, TH was diagnosed. Therefore, awareness of this event may prevent unnecessary investigations.