FAQ: What is Hypophosphatasia and How Does It Present Across the Lifespan?

January 2026

In this FAQ, Brandon Ko, APRN, a pediatric rheumatology nurse practitioner and RhAPP Pediatric Chair, provides a practical overview of hypophosphatasia (HPP) across the lifespan and explains why this rare inherited metabolic bone disorder is often missed in clinical practice. The discussion reviews pediatric and adult presentations of HPP, including subtle skeletal symptoms, premature tooth loss with intact roots, stress fractures, osteomalacia, and early-onset pseudogout, and highlights persistently low alkaline phosphatase as a key diagnostic red flag. Designed for APPs and clinicians, this concise video outlines when to suspect HPP, how to begin the evaluation, and why early recognition is critical in both pediatric and adult rheumatology settings.