What is the role of lab studies in the evaluation of hypoalbuminemia?

Updated: Sep 11, 2020
  • Author: Ruben Peralta, MD, FACS; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Clinical suspicion of the underlying disease process should guide appropriate laboratory studies, some of which are as follows:

  • Malnutrition: Lymphocyte count and blood urea nitrogen levels are decreased. Transferrin, prealbumin, and retinol-binding protein have shorter half-lives compared with albumin and better reflect short-term changes in nutritional status than albumin, which has a long half-life.

  • Inflammation: C-reactive protein levels and increased erythrocyte sedimentation rate are elevated.

  • Nephrotic syndrome: The 24-hour urine collection contains more than 3 g of protein in 24 hours.

  • Cirrhosis: Liver function test findings (transaminase levels) may be elevated or normal in patients who are cirrhotic. Coagulation studies may be abnormal. Cirrhosis has numerous potential etiologies, and more specific studies, such as hepatitis screening, may be needed.

  • Malabsorption: Fecal fat studies including Sudan qualitative stain for fat, 72-hour quantitative fecal fat collection, and fecal a-1-antitrypsin clearance are needed.

Serum protein electrophoresis results help to determine if hypergammaglobulinemia is present.

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