First-line laboratory finding in Paget's disease is an elevation of which enzyme?

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Study for the CMS II Rheumatology E1 Test. Boost your knowledge with flashcards and multiple choice questions. Each question includes helpful hints and explanations. Prepare to excel on your exam!

Multiple Choice

First-line laboratory finding in Paget's disease is an elevation of which enzyme?

Explanation:
Paget's disease causes rapid, disorganized bone remodeling with markedly increased osteoblastic activity. Alkaline phosphatase is a marker of bone formation, so it rises when bone turnover is up. This makes elevated alkaline phosphatase the most consistent and early laboratory finding. Calcium and phosphate usually stay normal because systemic calcium balance is preserved, so you wouldn’t expect high calcium or low alkaline phosphatase in this setting. Low ALP would suggest reduced bone formation, which isn’t the process here.

Paget's disease causes rapid, disorganized bone remodeling with markedly increased osteoblastic activity. Alkaline phosphatase is a marker of bone formation, so it rises when bone turnover is up. This makes elevated alkaline phosphatase the most consistent and early laboratory finding. Calcium and phosphate usually stay normal because systemic calcium balance is preserved, so you wouldn’t expect high calcium or low alkaline phosphatase in this setting. Low ALP would suggest reduced bone formation, which isn’t the process here.

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