Hypalbuminemia is the name given to a form of hypoproteinemia. This is when there is too little albumin in the blood. Albumin is a plasma protein that is responsible for transporting many small-particle molecules. A deficiency of this protein can therefore cause various disorders such as the formation of edema and low blood pressure.
What is hypalbuminemia?
In medicine, hypalbuminemia is also known as hypoalbuminemia. It represents the most common form of hypoproteinemia, in which there is a decreased level of proteins (albumin) in the blood plasma. In the case of hypalbuminemia, the blood shows too low a level of albumin. Albumin is an important protein in the human body. It produces more than 50 percent of all proteins found in blood vessels. Albumin is formed in the liver and is produced by liver cells (hepatocytes). The normal total amount of albumin in the body is over 300 grams. Albumin is important as a carrier for numerous other substances, which include trace elements, hormones, bilirubin and fatty acids. In addition, the protein is responsible for maintaining 75 to 80 percent of the colloid osmotic pressure. If there is a pathological deficiency of albumin in the blood, this leads to the development of edema (water retention) in the body due to a lowered colloidosmotic pressure. Albumin is also important for the binding of various drugs. In hypalbuminemia, these drugs are freely present in the blood plasma, which in turn results in higher drug levels.
Causes
Normally, the human body maintains a constant level of albumin within the blood. If there is a lower synthesis compared with a loss, this results in a lowering of the protein. Possible causes of hypalbuminemia include reduced albumin production due to permanent damage to the liver, kidney damage, or malnutrition. Likewise, loss of albumin can result from burns with large wound areas or acute inflammation. Other possible causes include protein-losing enteropathy or exudative pancreatitis (inflammation of the pancreas). A disturbance of protein synthesis can also be observed in an antibody deficiency syndrome or liver cirrhosis. Furthermore, food intolerances such as celiac disease, anorexia nervosa (anorexia) and gastrointestinal tumors may be responsible for albumin loss. Physiological hypalbuminemia occurs during pregnancy, which usually occurs in the 3rd trimester. It is the result of proteinuria and provides for the development of edema in pregnant women. The causes are both increased plasma volume and increasing glomerular patency. This results in increased renal excretion of albumin. If albumin loss through the urine is more than 300 milligrams per day, this is no longer considered harmless and may indicate the onset of preeclampsia. If the loss exceeds three grams of the protein per day, it is considered a severe loss.
Symptoms, complaints, and signs
The lack of albumin in the body causes a drop in colloid osmotic pressure within the blood plasma. As a result, water cannot be maintained in physiologic amounts within the vascular system. Therefore, there is an overflow into the interstitium (intercellular space). This in turn results in the formation of edema. Albumin is the protein most abundant in the human organism. It is also responsible for the transport of drugs and hormones. Therefore, the lack of the protein affects their effect. Other symptoms of protein deficiency include low blood pressure, pleural effusion and ascites. In this case, a larger amount of fluid accumulates between the organs in the abdominal cavity. In the case of a pleural effusion, on the other hand, water accumulates in the lungs. In the case of a water belly, there is a risk of intestinal bacteria entering the abdominal cavity, which in turn can result in a threatening infection. Not infrequently, the lack of albumin leads to increased concentration of fatty acids, hormones and bilirubin in the blood. Thus, the absorption capacity of albumins is too low due to hypalbuminemia.
Diagnosis and course of the disease
If hypalbuminemia or hypoproteinemia is suspected, a physician should be consulted. Based on the symptoms, the physician can initially only make a tentative diagnosis.Low albumin concentration can be detected by serum protein electrophoresis, which reveals a decreased albumin peak. Measurement of serum albumin is also possible. Deficiency of albumin can be distinguished from too low a concentration of immunoglobulins. Because hypalbuminemia does not manifest itself alone, the triggering underlying disease must also be diagnosed. Thus, identifying the causes is of paramount importance for the subsequent therapy. For hypalbuminemia to take a positive course, it is important to treat the underlying disease responsible. In the case of chronic diseases, permanent therapy may be required. If the triggering cause is successfully addressed, this usually leads to normalization of the albumin concentration.
Complications
Hypalbuminemia results in relatively low blood pressure in the patient in most cases. Furthermore, various other complaints and symptoms may also occur due to the deficiency of the protein and complicate the daily life of the affected person. The reduced blood pressure also reduces the patient’s ability to cope with stress, so that sporting activities or physical exertion can usually no longer be performed. It is not uncommon for fainting spells to occur, during which the affected person can also injure himself. The patient appears tired and weary and often no longer takes an active part in life. Furthermore, there is a so-called water belly, which can lead to various infections and inflammations. The immune system of the affected person is also weakened, so that he or she falls ill more often with infections and inflammations. There are usually no special complications during the treatment. Treatment is always causal and depends on the underlying disease that is responsible for the hypalbuminemia. Not infrequently, hypalbuminemia is called by malnutrition, so the treatment should be accompanied by a psychologist in any case.
When should you go to the doctor?
If symptoms such as low blood pressure or signs of a watery belly are noticed, hypalbuminemia may be underlying. A physician should be consulted if symptoms persist over a long period of time or cause severe discomfort as they progress. Thus, with dizziness, fatigue or severe pain, a visit to the family doctor must be made in any case. Effusions and infections that seem to occur for no reason also require rapid clarification. Patients suffering from malnutrition due to an eating disorder are particularly susceptible to hypalbuminemia. There is also an increased risk of low albumin levels in the blood following major burns or acute inflammation. Anyone who belongs to these risk groups should go to the doctor immediately with the symptoms mentioned. Elderly people and pregnant women should also have unusual symptoms clarified quickly to avoid complications. Children are best taken to the pediatrician. In severe cases, such as increasing pain or acute inflammation, a visit to the hospital is always indicated.
Treatment and therapy
Treatment of hypalbuminemia is accompanied by therapy of the underlying disease that is causative for the albumin deficiency. If there is leakage of water from the blood vessels, this is stopped. In this way, the edema recedes. In the case of a pronounced water belly, a puncture through the abdominal wall can be performed to drain the excess water. Diuretics are also prescribed to remove the water retention. In the case of malnutrition due to anorexia, psychotherapy is often useful. The diet must also be adjusted accordingly.
Outlook and prognosis
The prognosis of hypalbuminemia depends on the causative disease. In the absence of medical care, the prognosis in these patients can be described as unfavorable. If the course of the disease is difficult, organ damage is present and a donor organ is needed. Alternatively, the affected person faces premature death. If the underlying disease can be treated well, the prognosis is favorable. In the case of malnutrition, the missing nutrients or trace elements are compensated for, so that the patient is free of symptoms after a few weeks or months. However, a relapse is possible at any time as soon as the deficiency reappears. If severe burns are present, the prospect of healing worsens. A skin transplant is often required.In addition, long-term therapy is necessary to alleviate the symptoms. Chronic diseases normally have a protracted course of disease. For many patients, a cure is possible, but it can sometimes take years before improvement occurs. In addition to physical irregularities, psychological stability must be considered to promote recovery. If intolerance is present, symptom-free hypalbuminemia can be achieved if all guidelines are followed. If the patient pays strict attention to the ingredients in the intake of food or medicine, the development of anemia can be adequately prevented.
Prevention
Because of the numerous underlying diseases that can cause hypalbuminemia, no useful preventive measures are known. If the underlying disease can be identified, its treatment is considered the best preventive measure.
Follow-up
In hypalbuminemia, the affected person usually has no special options and measures of aftercare available. In this case, the affected person is primarily dependent on early detection and treatment of this disease, so that there is no further worsening of the symptoms or further complications. As a rule, in hypalbuminemia the underlying disease must first be recognized and then treated. Only through proper treatment of the underlying disease can the symptoms be completely relieved. In this case, the treatment is done by draining the water, and most of the affected people also have to take medication. Care must be taken to ensure that the medication is taken correctly and also on a regular basis. In the case of children, parents must pay attention to the intake and consult a doctor if they have any questions or are unclear. Since hypalbuminemia can also lead to depression or psychological upsets, psychological therapy should be started early. Loving care and support from friends and family also have a very positive effect on the further course of the disease. In many cases, attention should also be paid to proper nutrition to counteract this deficiency.
What you can do yourself
In the treatment of hypalbuminemia, the physician focuses on therapy of the underlying disease. This is usually done by means of antibiotics and diuretics. However, patients can also take some measures themselves to promote recovery and reduce the risk of complications. If the symptoms are due to malnutrition, the diet must be changed. To do this, the patient should consult a specialist or a nutritionist. Together with the specialist, an individual diet plan can be drawn up that is geared to the physical complaints and optimally supports healing. This is often accompanied by psychotherapy, since persistent malnutrition is often the result of serious psychological problems. Patients suffering from anorexia should immediately visit a counseling center and make an appointment for further therapy. In addition, the symptoms must be treated. Cooling and rest are helpful against pressure pain due to edema. Gentle ointments such as calendula ointment or arnica also help against corresponding complaints. If these measures show no effect, a doctor must be consulted. The same applies to unusual symptoms and acute pain.
