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hypoalbuminaemia

hypoalbuminaemia

see also:

Introduction

  • hypoalbuminaemia is often a marker of general illness and is associated with higher morbidity and mortality rates
  • albumin is a negative acute phase reactant in that serum levels FALL during acute inflammatory responses
  • albumin is a highly water-soluble protein, located mainly in the extra-cellular space, with a total body pool of approximately 300 g (3.5 to 5.3 g/kg) in a normal average man
  • albumin has a half-life of approximately 20 days
  • serum albumen levels are determined by the net reult of:
    • rate of synthesis by the liver
      • reduced due to:
        • long term protein malnutrition
        • hepatic disease such as cirrhosis which results in ascites
        • inflammatory disease
    • rate of breakdown
      • increase rate of breakdown during inflammation or liver disease
    • body pool size
      • hence short term reduced protein intake is unlikely to decrease levels due to the relatively low turnover rate (long half life) and the large pool size
    • volume of distribution
    • exchange between intravascular and extravascular spaces
      • concentrations may actually increase during short-term fasting because of contraction of the intravascular space
    • losses from the body

Aetiology

  • acute phase response eg. severe infection
  • chronic liver disease
  • protein malnutrition
  • urine losses - nephrotic syndrome
  • skin losses - large burns
  • capillary leakage resulting in systemic oedema
    • some autoimmune diseases
    • ovarian hyperstimulation syndrome
    • viral hemorrhagic fevers
    • differentiation retinoic acid syndrome in those with APML leukaemia
    • haemophagocytic lymphohistiocytosis
    • ricin poisoning
    • some snakebites
    • chemotherapy such as with gemcitabine and tagraxofusp
    • certain interleukins and monoclonal antibodies
hypoalbuminaemia.txt · Last modified: 2021/06/13 10:27 by gary1