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DR Medhat MRCP

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Leucocyte alkaline phosphatase<br />

• Raised in<br />

Myelofibrosis.<br />

Leukaemoid reactions.<br />

Polycythaemia rubra vera.<br />

Infections.<br />

Steroids, Cushing's syndrome.<br />

Pregnancy, oral contraceptive pill.<br />

• Low in<br />

Chronic myeloid leukaemia.<br />

Pernicious anaemia.<br />

Paroxysmal nocturnal haemoglobinuria.<br />

Infectious mononucleosis.<br />

Haematological malignancies: infections<br />

• Viruses<br />

EBV: Hodgkin's and Burkitt's lymphoma, nasopharyngeal carcinoma<br />

HTLV-1: Adult T-cell leukaemia/lymphoma<br />

HIV-1: High-grade B-cell lymphoma<br />

• Bacteria<br />

Helicobacter pylori: gastric lymphoma (MALT)<br />

• Protozoa<br />

Malaria: Burkitt's lymphoma<br />

Lymphadenopathy<br />

• Infective<br />

Infectious mononucleosis<br />

HIV, including seroconversion illness<br />

CMV<br />

Eczema with secondary infection<br />

Rubella<br />

Toxoplasmosis<br />

Tuberculosis<br />

Roseola infantum<br />

• Neoplastic<br />

Leukaemia<br />

Lymphoma<br />

• Others<br />

Autoimmune conditions: SLE, rheumatoid arthritis<br />

Graft versus host disease<br />

Sarcoidosis<br />

Drugs: phenytoin and to a lesser extent allopurinol, isoniazid.<br />

81

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