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Causes of elevated acid phosphatase
Last reviewed: 06.07.2025
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Acid phosphatase is found in almost all human organs and tissues, in the largest quantities - in blood cells, prostate gland, liver, kidneys, bones. The enzyme is also found in breast milk.
The activity of acid phosphatase in the prostate gland is 100 times higher than in other tissues. In men, half of the acid phosphatase in the blood serum is produced by the prostate gland, the rest by the liver and by degraded platelets and red blood cells.
In women, the enzyme is produced by the liver, red blood cells, and platelets. Acid phosphatase is not a homogeneous enzyme. Most tissues contain two or more isoenzymes that differ in their properties.
Reference values (norm) for acid phosphatase activity in blood serum are 0-6.5 IU/L.
Determination of acid phosphatase activity in clinical practice is usually performed to diagnose prostate cancer. Acid phosphatase activity does not always increase in prostate cancer: only in 20-25% of patients without metastases and in 60% of patients with metastases. The degree of increase in acid phosphatase activity is especially high in patients with bone metastases.
Determination of acid phosphatase activity can be used for differential diagnosis of prostate cancer metastases to bone and bone diseases, in particular osteodystrophies, in which alkaline phosphatase activity is usually increased, while in prostate cancer metastases to bone, the activity of both alkaline and acid phosphatases is increased.
It should be borne in mind that prostate massage, catheterization, cystoscopy, and rectal examinations increase the activity of acid phosphatase, so blood for testing should be taken no earlier than 48 hours after the above procedures.
An increase in acid phosphatase may occur with increased destruction of platelets (throbocytopenia, thromboembolism, etc.), hemolytic disease, progressive Paget's disease, metastatic bone lesions, myeloma (not always), Gaucher's disease and Niemann-Pick disease, 1-2 days after surgery on the prostate gland or after its biopsy.
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