Hypoproteinemia - causes, treatment, symptoms, edema

Hypoproteinemia - is a condition in which the level of protein in the blood plasma is abnormally low. There are several reasons

Hypoproteinemia
ICD-10E77.8
ICD-9273.8 273.8
DiseasesDB6534
MeshD007019

  1. Nutritional hypoproteinemia is associated with extremely low protein intake with food (for example, kwashiorkor).
  2. Malabsorption
  3. Liver disease can also cause hypoproteinemia by reducing the synthesis of plasma proteins, such as albumin.
  4. Kidney diseases, such as nephrotic syndrome, can also lead to hypoproteinemia due to the fact that proteins are excreted in the urine.

The decrease in serum protein causes a decrease in blood oncotic pressure, which leads to the transfer of fluid from the vascular bed to the interstitium of the tissue, as a result of which edemas develop.

What are the symptoms?

Symptoms of hypoproteinemia include:

  • swelling in the legs, face and other parts of the body from the accumulation of fluid
  • muscle loss
  • dry, brittle hair that falls out
  • lack of growth in children
  • cracks, bones of nails
  • infections
  • fatigue

Your body cannot properly absorb protein from the foods you eat.

The problem that absorbs protein from foods is called malabsorption. Possible reasons include:

  • celiac disease
  • Crohn's disease
  • parasites and other infections
  • damage to your pancreas
  • defects in your bowel surgery
  • including weight loss surgery or procedures that remove part of your intestines

Liver damage

Your liver makes a protein called albumin, which makes up about 60 percent of the total protein in your blood. Albumin contains vitamins, hormones and other substances throughout the body. It also prevents fluid from leaking out of your blood vessels (which is why fluid builds up in your body when your protein levels are low). Damage to the liver prevents albumin formation.

How is it treated?

You can treat low levels of protein in your diet by increasing the amount of protein you eat. Foods that are good sources of protein include:

  • red meat
  • Domestic bird
  • a fish
  • tofu
  • eggs
  • the nuts
  • dairy products such as milk and yogurt

Children in developing countries who have kwashiorkor are processed with a ready-to-use therapeutic product (RUTF), which is made from:

  • peanut butter
  • milk powder
  • sugar
  • vegetable oil
  • vitamins and minerals

Other treatments depend on the cause of the low protein and may include:

  • antibiotics or antiparasitic drugs for treating infections
  • vitamin and mineral supplements to treat any other nutrient deficiencies
  • gluten-free diets to treat your intestinal damage from celiac disease
  • steroids, suppressors of the immune system and other drugs to reduce inflammation in the intestines
  • medication or surgery to treat liver damage
  • dialysis or kidney transplant for kidney disease

If you have a problem absorbing protein from the foods you eat, your doctor will treat the condition causing bsorption.

During pregnancy

Is it possible to prevent this?

You can prevent hypoproteinemia by getting enough protein in your diet. The recommended daily dose of protein (RDA) is 8 g of protein for every 20 pounds of body weight. Therefore, if you weigh 140 pounds, you will need about 56 grams of protein per day. (This number may vary slightly depending on gender and level of activity.)

If you are a vegetarian or vegan, eat more plant-based sources of protein, such as:

  • soy and almond milk
  • tofu tempeh
  • beans
  • legumes (lentils, peas)
  • nuts (walnuts, almonds, pistachios)
  • nut butter
  • whole grain bread
  • If you have a condition such as liver disease, kidney disease, infection, celiac disease, or Crohn's disease, follow the recommended doctor. Getting treatment will help improve your body's ability to absorb proteins and other nutrients from food.

Diagnostics

The main diagnostic criterion for hypoproteinemia is a decrease in plasma protein concentration to a level of less than 60 g / l, which is determined in the course of a blood test by laboratory means.

Since in most cases a decrease in the amount of protein in the blood is a symptom of the underlying pathological condition, the treatment is aimed at eliminating the underlying disease:

  • diet correction,
  • nephroprotective agents (in renal pathology),
  • hepatoprotectors (for liver diseases),
  • correction of water-salt balance (in acute infectious processes, accompanied by massive loss of fluid),
  • infusion therapy (with massive blood and plasma loss),
  • correction of hormone levels (in diseases of the thyroid and parathyroid glands),
  • pro-and prebiotic agents (for bowel disease),
  • vitamin therapy, etc.

Hypoproteinemia, developed during pregnancy, may be one of the signs of late toxicosis (gestosis).

Prevention

In order to prevent the development of hypoproteinemia are necessary:

  • timely treatment of diseases contributing to its development,
  • formation of an adequate diet with enough protein, minerals, vitamins.

Education: higher, 2004 (GOU VPO “Kursk State Medical University”), specialty “General Medicine”, qualification “Doctor”. 2008-2012 - Post-graduate student of the Department of Clinical Pharmacology of the SBEI HPE "KSMU", Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".

The information is generalized and is provided for informational purposes only. At the first signs of illness, consult a doctor. Self-treatment is dangerous for health!

Protein functions

Total protein is the combination of all protein compounds, such as albumin, fibrinogen, globulin, glycoproteins, etc. In total, their number includes about 300 items, but this list is constantly updated.

Read about albumin in the blood test here. What analysis shows on globulins is discussed in detail here.

Some types of proteins constantly circulate in the blood, maintaining the body's performance, while others appear only in times of danger, for example, immunoglobulins, which are responsible for the immune response to stimuli or disease-causing organisms.

Typically, high blood protein levels are associated with the fact that albumin or globulin is produced much more than is consumed.

In blood, the total protein performs the following tasks:

  1. Participates in the distribution of fluid between and inside the vessels.
  2. Participates in blood clotting.
  3. It transports hormones through tissues, some medications, microelements, etc.
  4. Takes part in enzyme reactions.
  5. Makes up an immune response to protect the body.
  6. Maintains water-salt, acid-base balance,
  7. It performs the functions of receptors and hormones.

Each of these roles is of great importance for life and normal well-being. If there is an increased total protein in the blood, it is necessary to determine and eliminate the cause of this deviation. But before analyzing a high concentration of total protein, it is necessary to know the rate of its content.

The rate of total protein in the blood

Optimal rates depend on the age of the patient. Measured in grams per liter (g / l). The average rate for an adult is 65-88 g / l. We give reference values ​​depending on age.

Any increase in the concentration of total protein in the blood compared with the norm is called hyperproteinemia, regardless of what reasons it was caused. So we can say that hyperproteinemia is not a specific disease, but a symptom that is caused by a disruption in the functioning of some organ or system. If the total protein, on the contrary, is too low, they are talking about hypoproteinemia, the causes and the specific disease are investigated separately.

Protein increased in the blood: what does it mean?

There are absolute, relative and physiological deviation from the optimal indicators of total protein. This classification is typical for hyper-and hypoproteinemia.

For an absolute decrease or increase in total protein in the blood, the causes are associated with a change in the number of protein compounds themselves by the same amount of fluid in the bloodstream. This phenomenon is less common than relative.

Relative deviation is the preservation of the amount of proteins at the same level, but an increase or decrease in the volume of water in the blood plasma.

Physiological causes, when elevated protein in the blood, are not associated with the disease. This includes improper preparation of the patient for analysis or violation of the methodology for its conduct by a laboratory assistant. For example, if he presses the skin for too long before taking blood. At this point, part of the water is lost in the tissues, and an elevated level of blood cells, including proteins, remains at the site of blood collection. However, it is extremely erroneous to write off an exaggerated result for these reasons. If you doubt the accuracy of the analysis, donate blood again.

Diseases characteristic of absolute hyperproteinemia:

  • Oncology of the lymphatic system (Hodgkin's disease),
  • Hepatitis,
  • Cirrhosis of the liver,
  • Sarcoidosis
  • Autoimmune,
  • Oncology of other types: myeloma, bone marrow neoplasms, heavy chain disease.

Relative elevated protein in the blood indicates dehydration. The water level decreases, so the concentration of proteins increases, although their number remains the same. This can be observed with diarrhea, vomiting, extensive burns, diabetes insipidus, increased sweating, intestinal obstruction, etc.

The causes of hyperproteinemia are almost always associated with diseases, so it is very important to detect and, if possible, eliminate its cause in time.

Total protein in the blood is increased and decreased in pregnant

Low levels of protein in the blood of a pregnant woman can be fraught with preeclampsia. A decrease in the protein in the blood entails several consequences at once: a decrease in the osmotic pressure in the blood, an increase in the permeability of the vessels, the release of protein into the extracellular space.

Pregnancy hypoproteinemia can cause oxygen starvation and fetal thrombocytopenia. In addition, there is even a threat to the life of the child and mother. When obtaining a similar result of a blood test, it is important to quickly conduct a series of procedures for the treatment of hypoproteinemia and restoration of the protein norm.

At the same time, the scope of the norms of total protein for pregnant women is significantly expanded. After all, a decrease in its concentration to 30% is considered a healthy manifestation. It is explained by the fact that proteins are spent on the construction of new tissues, besides the fluid is retained in the vascular space.

Increased protein in the blood during pregnancy is less common than reduced. This condition may be due to the same diseases that were mentioned above for hyperproteinemia: chronic and acute infections, cancer, dehydration, autoimmune diseases, etc.

A reduced or elevated total protein in a biochemical blood test is, of course, a reason for further examination of the patient. Use only the data of this analysis for diagnosis. Also, you can not engage in independent search for the cause and its solutions. If the protein is elevated in the blood or the opposite is observed, it is important to provide the doctor with the opportunity to correct this deviation.

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What is hypoproteinemia

Hypoproteinemia is a disease that causes a decrease in protein concentration in the blood plasma, which leads to the development of other pathological processes in the body. The disease is especially dangerous during late pregnancy, as it provokes the development of severe toxicosis.

It should be noted that this pathological process is rarely independent. In most cases, this is a consequence of malnutrition, chronic, systemic or autoimmune diseases in the body. A little less, but still there is a genetic form of the disease.

Symptomatology is rather non-specific in nature, since the main symptom is swelling of the face and extremities, which is also possible with diseases of the genitourinary system. The treatment is conservative, if surgical intervention is not required due to concomitant diseases.

The prognosis, subject to timely initiated therapeutic measures, is favorable. However, it is necessary to take into account the possible underlying cause of hypoproteinemia, which can only be eliminated by surgery.

According to the international classification of the disease of the tenth revision, this pathological process belongs to the section of pathologies, which are caused by a violation of plasma protein metabolism, which are not classified elsewhere. Thus, the code on the ICD 10 - E88.0.

Causes of hypoproteinemia

As mentioned above, hypoproteinemia is most often the result of certain pathological processes or malnutrition. As for diseases and conditions, here it is necessary to highlight the causes of hypoproteinemia, such as:

  • mutation of a gene that controls protein synthesis by hepatocytes,
  • congenital diseases that are characterized by impaired absorption and protein digestion,
  • Fanconi syndrome
  • pronounced hypovitaminosis,
  • hyperthyroidism
  • Itsenko-Cushing syndrome
  • gastroenterological diseases, in the pathogenesis of which - a violation of protein absorption,
  • liver cell immaturity
  • prematurity of the fetus.

In addition, predisposing factors should be singled out for the development of such a pathological process, namely:

  • starvation or, on the contrary, overeating,
  • skin inflammatory diseases
  • acute infectious diseases
  • oncological processes
  • congestion in the circulatory circles, which will lead to puffiness,
  • fetal hypoxia,
  • dyspeptic disorders.

In more rare cases, hypoproteinemia remains etiologically unidentified. In such cases, talk about the idiopathic form of the disease.

Hypoproteinemia during pregnancy is often manifested, which may be due to improper feeding of the mother, the presence of chronic diseases and a weak immune system. In any case, only the doctor can determine the exact cause of the development of such pathology. It is impossible to do it yourself.

Classification

Depending on the cause, consider the following types of this pathological process:

  • primary - has the nature of a root cause pathology, may have a hereditary form,
  • secondary - develops against the background of another pathological process, chronic or systemic disease, as a result of extensive injuries,
  • physiological,
  • pathological.

By origin, hypoproteinemia can be:

  • absolute or true,
  • relative or false.

Determine exactly what form of the disease occurs in a particular clinical case, can only a doctor by carrying out the necessary diagnostic procedures. Based on this, treatment will be prescribed.

Symptoms of hypoproteinemia

The clinical picture of this pathological process is somewhat non-specific. At the initial stage of development symptoms may be absent altogether.

In general, the symptom complex is characterized as follows:

Hypoproteinemia in pregnant women can be a sign of late toxicosis, which in itself is a dangerous pathological process at this stage of carrying a child.

The clinical picture in this case can be characterized as follows:

  • increased amount of protein in the urine,
  • sharp weight gain
  • hypertonus of the uterus,
  • severe edema syndrome
  • hypertension.

This condition is dangerous for both the mother and the child, so you need to immediately seek medical help, and not to treat yourself.

Treatment of hypoproteinemia

If the pathological process is secondary, then the main course of therapy will be aimed at eliminating the underlying cause, and the treatment of hypoproteinemia will be symptomatic and consist of the following measures:

  • adherence to a special diet
  • correction of water-salt balance
  • infusion therapy,
  • receiving hepatoprotectors and neuroprotectors,
  • hormonal drugs,
  • vitamin therapy.

Surgical intervention may be required only with respect to the underlying cause. The elimination of hypoproteinemia is carried out only by conservative methods.

Provided that therapeutic measures are started in time, the prognosis will be favorable, complications are excluded.

Features of flow in pregnant women

Hypoproteinemia, developed during pregnancy, may be one of the signs of late toxicosis (gestosis). Preeclampsia is a serious condition that increases the risk of perinatal mortality by about 5 times compared with the average sample of healthy pregnant women.

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Prognosis and prevention of hypoproteinemia

If hypoproteinemia is triggered by an unbalanced diet, then the prognosis for recovery is as favorable as possible. In other cases, it depends on the original cause of the drop in protein in the blood. Developing nephropathy in pregnant women most often requires interruption.

In order to prevent hypoproteinemia, it is necessary to eat properly and balanced, as well as timely treat diseases of the liver, kidneys and organs of the digestive system.

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