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Transient hyperphosphatasemia (TH) is a benign condition in which serum alkaline phosphatase (ALP) is transiently elevated in the absence of other systemic diseases. It rarely occurs in infants and children under 5 years and is very rarely seen in adults. The differential diagnosis may include bone, intestinal, liver, kidney, intestinal, placental and blood diseases as well as other serious conditions, as well as bone fracture due to accidental or non-accidental injuries. The exclusion of such differential diagnosis before establishing the diagnosis of TH is crucial. We present a case of a nine-month-old girl who was found to have transient hyperphosphatasemia, while she was being investigated for failure to thrive. This case report aims to reinforce that hyperphosphatasemia is a benign phenomenon and diagnostic procedures that are invasive and costly should be avoided.

Transient hyperphosphatasemia of infancy and early childhood: a less common encounter - a concern for the paediatrician