Finally, precipitously low ALP levels are observed in critical situations, such as major trauma, major surgery, cancer, chemotherapy, conditions necessitating massive blood transfusions, starvation, sepsis, multiorgan or hepatic failure, and improperly collected specimens (e.g., those contaminated with ethylenediaminetetraacetic acid, citrate, or oxalate).13 The gene discussed is ALPP; the disease is Sepsis.