Changes

==Description==

==Description==

Hypoalbuminaemia refers to a reduced blood level of albumin, one of the major plasma proteins which is synthesised in the liver.  Albumin has multiple physiological functions including exertion of 75% of the total plasma oncotic pressure (to prevent leakage of fluid into body cavities and the interstitium), carriage of drugs and hormones in the blood (particularly thyroid and reproductive hormones and non-steroidal anti-inflammatory drugs, thiopental sulphate and frusemide) and buffering of blood pH changes.  Albumin has a circulating half-life of 17-19 days.

Hypoalbuminaemia refers to a reduced blood concentration of albumin, one of the major plasma proteins which is synthesised in the liver.  Albumin has multiple physiological functions including exertion of 75% of the total plasma oncotic pressure (to prevent leakage of fluid into body cavities and the interstitium), carriage of drugs and hormones in the blood (particularly thyroid and reproductive hormones and non-steroidal anti-inflammatory drugs) and buffering of blood pH changes.  Albumin has a circulating half-life of 17-19 days and its normal serum concentration is 25-40 g/l.

==Causes of Hypoalbuminaemia==

==Causes of Hypoalbuminaemia==

The synthesis of albumin may be reduced or it may be lost in greater quantities than normal:

The synthesis of albumin may be reduced or it may be lost in greater quantities than normal:

*Reduced synthesis of albumin

*Reduced synthesis of albumin

**'''Severe malnutrition''' resulting in the inability to synthesise sufficient albumin

**'''Severe malnutrition''' resulting in the inability to synthesise sufficient albumin, also known as '''protein energy malnutrition'''.

**'''Acute phase response''', in which the production of positive acute phase proteins is favoured at the expense of negative acute phase proteins like albumin and transferrin.  Globulins will be elevated in this response, with a reduced albumin: globulin ratio.

**Elaboration of an '''acute phase response''', in which the production of positive acute phase proteins (such as globulins and c reactive protein) is favoured at the expense of negative acute phase proteins like albumin and transferrin.  Globulins will be elevated in this response, with a reduced albumin: globulin ratio.

**'''Severe hepatic damage''', as in chronic liver failure, cirrhosis or with congenital porto-systemic shunts.

**'''Severe hepatic insufficiency''', as in chronic liver failure or with congenital porto-systemic shunts.

*Increased loss of albumin

*Increased loss of albumin

**'''Severe exudates''' that contain large quantities of protein may deplete the plasma proteins:

**'''Severe exudates''' that contain large quantities of protein may deplete the plasma proteins:

***'''Dermal protein loss''' with severe thermal or chemical burns.

***'''Dermal protein loss''' after severe thermal or chemical burns.

***'''Septic peritonitis''' with exudative peritoneal fluid.

***'''Septic peritonitis''' involving copious amounts of exudative peritoneal fluid.

**[[Protein Losing Enteropathy|'''Protein-losing enteropathy''']] (PLE) caused by [[Inflammatory Bowel Disease|inflammatory bowel disease]], [[Lymphangiectasia|lymphangiectasia]] or alimentary lymphoma.  Globulins and, in severe cases, whole blood are lost with albumin in this condition.

**[[Protein Losing Enteropathy|'''Protein-losing enteropathy''']] (PLE) caused by [[Inflammatory Bowel Disease|inflammatory bowel disease]], [[Lymphangiectasia|lymphangiectasia]] or [[Alimentary Lymphoma|alimentary lymphoma]].  Globulins and, in severe cases, whole blood are lost with albumin in this condition.

**'''Protein-losing nephropathy''' (PLN) caused by primary glomerulopathy, glomerulonephritis or amyloidosis.  Albumin, having a smaller molecular weight, is lost in great excess of globulin.  Severe PLN results in Nephrotic Syndrome characterised by severe hypoproteinaemia, hypercholesterolaemia and ascites, hydrothorax and subcutaneous oedema.

**'''Protein-losing nephropathy''' (PLN) caused by primary glomerulopathy, glomerulonephritis or amyloidosis.  Albumin, having a smaller molecular weight, is lost in great excess of globulin.  Severe PLN results in Nephrotic Syndrome characterised by severe hypoproteinaemia, hypercholesterolaemia, ascites, hydrothorax and subcutaneous oedema.

**'''Acute haemorrhage''' followed by autotransfusion (movement of fluid into the circulation from the interstitium) will result in dilution of the remaining plasma proteins.

**'''Acute haemorrhage''' followed by autotransfusion (movement of fluid into the circulation from the interstitium) will result in dilution of the remaining plasma proteins.

*Apparent hypoalbuminaemia may occur in '''overhydrated or hypervolaemic animals''' suffering from primary (pyschogenic) polydipsia or which have received intra-venous fluid therapy.   

*Apparent hypoalbuminaemia may occur in '''overhydrated or hypervolaemic animals''' suffering from primary (pyschogenic) polydipsia or which have received intra-venous fluid therapy.   

   

   

==Consequences of Hypoalbuminaemia==

==Consequences of Hypoalbuminaemia==

==Diagnosis==

==Diagnosis==

 

[[Category:To_Do_-_James]]

[[Category:To_Do_-_James]]