What is your approach to isolated alkaline phosphatase without other laboratory abnormalities?

Assuming none of the other LFTs are abnormal, I would get a GGT.

If GGT is elevated --> likely a hepatobiliary issue. Would consider age, medical history, and risk factors. If persistently elevated, could consider RUQ US + MRCP. Conditions like PSC or PBC are frequently discovered due to asymptomati...