Hypoproteinemia is characterized by decreased protein concentration in the blood plasma. It is not a disease in its own right, but often develops as a result of various disorders.
What is hypoproteinemia?
In hypoproteinemia, protein concentrations in blood plasma are below 6 g/dL. Normally, protein levels in an adult range from 6.1 – 8.1 g/dl. Hypalbuminemia occurs most frequently. In this case, significantly decreased albumin concentrations are present. Less commonly, immunoglobulins are decreased. Albumin deficiency leads to edema and increased fatty acid, bilirubin, and hormone concentrations in the blood. Immune defenses are weakened in immunoglobulin deficiency. As a symptom of specific underlying diseases or functional disorders, hypoproteinemia cannot be defined as an independent disease.
Causes
There are basically four complexes of causes for hypoproteinemia. It may develop on the basis of malabsorption, malnutrition, high protein losses, or protein synthesis disorders. There are several conditions characterized by decreased protein absorption in the intestine (malabsorption). These include food allergies, food intolerances such as celiac disease or sprue, chronic intestinal diseases and cystic fibrosis. Malnutrition occurs with hunger, anorexia nervosa (anorexia) or tumors in the gastrointestinal tract. Furthermore, there are diseases that lead to severe protein losses. Kidney diseases in particular, such as nephrotic syndrome, are characterized by high protein losses. The body also loses a lot of protein in extensive burns and dermatoses. Disturbances in protein synthesis occur in liver cirrhosis and antibody deficiency syndrome and then lead to hypoproteinemia.
Symptoms, complaints, and signs
Hypoproteinemia can manifest as a number of symptoms. Typically, edema develops during the course of the disease. This water retention can occur throughout the body and is sometimes associated with severe pain, increased risk of infection, and other discomfort. Skin irritations such as itching and pain often accompany the condition. Hypoproteinemia can also lead to ascites, which in turn is associated with a number of symptoms and discomforts. For example, gastrointestinal symptoms such as bloating, diarrhea, nausea and vomiting often occur. In the long term, weight loss may occur. Hypoproteinemia is usually accompanied by low blood pressure, associated with dizziness and other disorders of consciousness. In the course of the disease, there is an increased incidence of infections and inflammations. Depending on the severity of the disease, the weakened immune system may cause further health problems. Furthermore, hypoproteinemia can cause damage and discomfort to the internal organs. If the disease is not treated, it can be fatal. There is also an increased risk of long-term damage to the immune system. In the worst case, untreated hypoproteinemia is fatal for the patient. Prior to this, symptoms increase in intensity and eventually lead to unconsciousness and coma.
Diagnosis and progression
Hypoproteinemia is sometimes a consequence of life-threatening diseases and sometimes itself leads to situations that can become very dramatic. Due to immunoglobulin deficiency, dangerous infections can occur because the immune system is weakened. However, most often there is a deficiency of albumins. This always leads to edema (accumulation of water in the tissues). In more severe cases, ascites or pleural effusion may occur. Ascites refers to an accumulation of water in the abdomen between the organs. A hunger belly is typical. Water can also accumulate in the lungs (pleural effusion). Particularly in ascites, bacteria sometimes pass from the intestines into the abdomen. In conjunction with the weakened immune system, these infections can be fatal. Water retention occurs as a result of a reduction in colloid osmotic pressure, also called oncotic pressure, in the blood vessels. This causes water to leak out through the blood vessels. At normal concentrations of colloidal protein particles, the oncotic pressure would be sufficient to prevent this fluid loss. In addition to edema, the patient also suffers from low blood pressure. At the same time, the concentration of fatty acids, bilirubin and hormones in the blood increases because the absorption capacity of the albumins for these substances is too low due to their deficiency.These symptoms lead to a suspected diagnosis of hypoproteinemia. Serum protein electrophoresis can be used to determine whether albumins or immunoglobulins are present in a lowered concentration. However, because hypoproteinemia usually does not occur in isolation, its causes should be determined to effectively treat the underlying disorder.
Complications
In most cases, hypoproteinemia does not occur alone, and in this case it always represents the consequence of an underlying disease. For this reason, the complaints and complications of the causative disease must always be considered in the foreground here. However, hypoproteinemia results in low blood pressure and ascites. Due to the low blood pressure, many patients suffer from dizziness and nausea and, in the worst case, may lose consciousness completely. In general, those affected feel weak and the patient’s ability to cope with stress decreases enormously. The immune system is also usually weakened and the affected person becomes ill more often and suffers more from infections and inflammations. The quality of life decreases relatively strongly due to hypoproteinemia. Furthermore, the disease can cause various damages and complaints to the internal organs of the body. As a rule, there is no symptomatic treatment of hypoproteinemia. Treatment is always causal and depends on the underlying disease. In most cases there is a positive course of the disease without complications. If necessary, the patient must change his diet to counteract the symptoms.
When should one go to the doctor?
If low blood pressure, edema, or signs of abdominal dropsy are noticed, a physician should be consulted promptly. Immediate medical attention is indicated if severe dizziness suddenly occurs, possibly associated with nausea and vomiting. If the affected person becomes unconscious, first responders must call the emergency physician and provide accompanying first aid. Severe infections or organ dysfunction must be treated in the hospital. Hypoproteinemia always requires medical clarification, because if left untreated, the disease can lead to serious complications and, in the worst case, be fatal. People suffering from chronic intestinal diseases, food allergies, cystic fibrosis and other diseases that can cause malnutrition should consult their family doctor if they have the above-mentioned symptoms and complaints. The physician can clarify the cause and refer the patient to an internist if necessary. If psychological or psychosomatic complaints develop in the course of the disease, a therapist must be consulted. With children, if hypoproteinemia is suspected, the patient should see a pediatrician.
Treatment and therapy
Treatment of hypoproteinemia is possible only in conjunction with treatment of the underlying disease. Once the cause of hypoproteinemia has disappeared, protein concentrations in the blood rapidly return to normal. Water leakage from blood vessels is stopped and edema regresses. In severe cases, ascites must be punctured through the abdominal wall and drained. Furthermore, the patient is given diuretics to remove the excess water from the body. However, it is important to treat the underlying disease in question. Malnutrition in anorexia often requires psychological therapy. In the case of celiac disease, attention must be paid to a gluten-free diet. Serious liver and kidney diseases must be treated individually according to the type and severity of the respective disorder. Permanent therapy is often necessary if the disease is chronic. In parallel, recurrent water retention in the abdomen and lungs should be removed by puncture in hypoproteinemia.
Prevention
No recommendation can be made for prevention from hypoproteinemia because its causes are diverse. Recommendations always apply only to the underlying disease in question. However, if the disease is known, hypoproteinemia can be prevented by its treatment.
Follow-up
Treatment of hypoproteinemia also includes subsequent therapy or aftercare. These later steps aim to determine the origin of the disease. To return blood protein concentrations to normal, there are some additional measures that patients themselves can help with. Often, a change in the diet is on the agenda.Everyday aftercare consists, for example, of a gluten-free diet with plenty of fruit and vegetables. Lean meat provides the necessary vital substances. Mineral water, diluted fruit juice and herbal tea are ideal for fluid intake. If the physician determines a disease of liver and/or kidney, there is a further approach for the health improvement. Here, an appropriate change in diet is also helpful. In the case of malnutrition, such as occurs in anorexia, patients should optimize their food intake. This usually requires a new body awareness, which in turn is closely linked to the psychological situation. For people suffering from an eating disorder, psychotherapeutic care is recommended. A nutrition expert can also help put together an individual diet. In this way, the body gradually and gently receives the necessary nutrients. In some cases, aftercare also involves the treatment of any edema that may be present. There are natural healing methods for this, such as massages or acupuncture.
What you can do yourself
Patients who have been diagnosed with hypoproteinemia may be able to take some steps themselves to support medical treatment. If celiac disease underlies the symptoms, the diet must be changed. The diet should be gluten-free and consist of healthy foods such as fruit, vegetables and lean meat. In addition, plenty of fluids should be consumed, preferably mineral water, herbal teas or diluted fruit juices. Accompanying this, any liver and kidney diseases must be treated. What the sufferer can do himself here depends on the nature of the disease. In general, a balanced diet supported by a healthy lifestyle with sufficient exercise and stress avoidance will also help here. If the hypoproteinemia is based on malnutrition, the daily food intake must be improved. Since chronic malnutrition is usually based on psychological causes such as anorexia or other eating disorders, a visit to a psychologist is recommended. In support of this, a suitable diet should be drawn up with a nutritionist, which gently supplies the body with all the necessary nutrients. For self-treatment of any edema, massage and acupuncture are among the options, always in consultation with the responsible physician.
