Symptom Finder-Hypoalbuminemia
HYPOALBUMINEMIA
The physiologic model of intake, absorption, transport, production, regulation, and excretion will help develop a list of causes of hypoalbuminemia.
Intake: Starvation and anorexia nervosa are recalled in this category.
Absorption: Poor absorption of dietary protein in the malabsorption syndrome is recalled in this category.
Transport: In CHF there is failure to eliminate water, causing hemodilution and, consequently, hypoalbuminemia.
Production: Albumin is produced in the liver, so chronic liver disease such as cirrhosis will be recalled in this category.
Regulation: Hyperthyroidism will cause the breakdown of plasma protein leading to hypoalbuminemia.
Excretion: In this category, one will recall the nephrotic syndrome or chronic renal failure, where protein is lost in the urine, and protein losing enteropathy in which protein is lost in the stool from a villous adenoma.
Miscellaneous conditions: These include metastatic neoplasm and infectious diseases such as TB that are associated with hypermetabolic states.
Approach to the Diagnosis
Clinically, look for weight loss, jaundice, or anemia. Laboratory workup usually includes CBC, urinalysis, 24-hour urine protein level, chemistry panel, protein electrophoresis, chest x-ray, and ECG.
Other Useful Tests
1. Liver function tests (cirrhosis)
2. Renal function tests (nephrosis)
3. ECG (CHF)
4. Arm-to-tongue circulation time (CHF)
5. CT scan of the abdomen (liver disease, renal disease, neoplasm)
6. Liver biopsy (cirrhosis)
7. Kidney biopsy (nephritis)
8. Nephrology consult
9. Hepatology consult
The physiologic model of intake, absorption, transport, production, regulation, and excretion will help develop a list of causes of hypoalbuminemia.
Intake: Starvation and anorexia nervosa are recalled in this category.
Absorption: Poor absorption of dietary protein in the malabsorption syndrome is recalled in this category.
Transport: In CHF there is failure to eliminate water, causing hemodilution and, consequently, hypoalbuminemia.
Production: Albumin is produced in the liver, so chronic liver disease such as cirrhosis will be recalled in this category.
Regulation: Hyperthyroidism will cause the breakdown of plasma protein leading to hypoalbuminemia.
Excretion: In this category, one will recall the nephrotic syndrome or chronic renal failure, where protein is lost in the urine, and protein losing enteropathy in which protein is lost in the stool from a villous adenoma.
Miscellaneous conditions: These include metastatic neoplasm and infectious diseases such as TB that are associated with hypermetabolic states.
Approach to the Diagnosis
Clinically, look for weight loss, jaundice, or anemia. Laboratory workup usually includes CBC, urinalysis, 24-hour urine protein level, chemistry panel, protein electrophoresis, chest x-ray, and ECG.
Other Useful Tests
1. Liver function tests (cirrhosis)
2. Renal function tests (nephrosis)
3. ECG (CHF)
4. Arm-to-tongue circulation time (CHF)
5. CT scan of the abdomen (liver disease, renal disease, neoplasm)
6. Liver biopsy (cirrhosis)
7. Kidney biopsy (nephritis)
8. Nephrology consult
9. Hepatology consult
