Hypoproteinemia, i.e. protein deficiency, causes various symptoms, such as edema or serious immune disorders. Proteins (proteins) perform many important tasks in our body, and the right amount of them is essential for the proper functioning of the system. What are the most common causes of protein deficiency? What other symptoms does hypoproteinaemia give? What is its treatment?

Hypoproteinemia , orprotein deficiencymost often occurs as a result of other serious diseases that contribute to their loss or impair the process of protein synthesis.

One of the most important indicators of hypoproteinemia in laboratory tests is the low concentration of total protein in the plasma, as well as its individual fractions (e.g. albumin or globulin).

More detailed diagnostics is necessary in order to understand the cause of this condition and the possibility of implementing appropriate treatment, it is worth remembering that long-term therapeutic effects in the fight against hypoproteinemia can only be obtained with effective causal treatment.

The immediate method is a high-protein diet or intravenous administration of those plasma proteins whose deficiency is the most dangerous.

Hypoproteinemia: causes

Hypoproteinaemia can be caused by excessive loss or insufficient synthesis of plasma proteins, leading to the following conditions:

  • intestinal diseases causing disorders of protein absorption, which leads to a deficiency of the substrate for the production of the body's own proteins
  • liver disease, i.e. the organ responsible for the synthesis of proteins, and as a result of its damage, the body does not produce enough of them
  • kidney disease causing what is known as nephrotic syndrome, characterized by proteinuria and an excessive loss of proteins from the body
  • congenital deficiency of plasma proteins, in this case due to damage to the metabolic pathways, some proteins are not produced at all
  • prolonged starvation (lasting for days), depleting the body's proteins
  • skin damage with exudate, e.g. after massive burns, the epidermal barrier is damaged, which leads to massive loss of fluids and proteins

An example of a bowel disease leading to hypoproteinemia isProtein-loss enteropathy, a set of symptoms caused by the escape of plasma proteins into the intestinal lumen through the mucosa or the lymphatic vessels.

In the latter case, it happens as a result of inborn defects of these vessels or their expansion caused by other diseases.

Obstructing the outflow of lymph and blood from the intestines with a significant intensification and increase in pressure in the vessels leads to the leakage of the fluid into the gastrointestinal tract. Examples of diseases leading to this state are:

  • heart failure
  • neoplastic diseases, the infiltration of which hinders the outflow of lymph from the intestines
  • cirrhosis of the liver significantly impairs blood flow through this organ
  • portal vein thrombosis and hepatic vein thrombosis

Loss of proteins through the mucosa of the gastrointestinal tract also occurs in the case of massive ulcerations occurring in inflammatory bowel diseases or cancer, and also when the membrane permeability is increased, e.g. in celiac disease, some infections of the digestive system and Menetrier's disease (excessive overgrowth of folds of the gastric mucosa). Protein lost in the described mechanisms is digested and excreted.

Advanced liver failure in which the function of protein synthesis is impaired is, for example :

  • alcoholism
  • severe course of infection caused by hepatitis viruses (hepatitis B and hepatitis C)
  • autoimmune diseases
  • birth defects
  • toxins
  • drugs

Another group of diseases that lead to hypoproteinemia is kidney disease, which causes nephrotic syndrome, i.e. excessive loss of protein in the urine. This is a group of ailments caused by e.g.

  • glomerulonephritis
  • diabetic kidney disease (occurs as a result of many years of diabetes)

Less common diseases are:

  • Amyloidosis - a disease in which the kidneys accumulate amyloid proteins that are toxic to them
  • Lupus Nephropathy
  • some cancers

Hypoproteinemia: symptoms

All the causes of protein deficiency reduce their amount in the place where they are most readily available to the body, i.e. in the plasma. This happens in various mechanisms, but such a state of affairs causes that the symptoms related to the loss of blood protein function are in the foreground of hypoproteinemia. These include:

  • edema (swelling) of the legs, less often fluid in the peritoneal cavity (ascites) caused by a lack of proteins maintaining osmotic pressure, in more advanced cases fluid in the pleura and in the pericardial sac
  • disordersimmunity caused by a lack of antibodies
  • coagulation disorders with a tendency to both clot formation and excessive bleeding depending on the cause of the disease and the protein fraction that will be deficient in the first place
  • pressure drops due to displacement of water from dishes

these symptoms are accompanied by:

  • weakness
  • deterioration of well-being
  • feeling tired
  • headaches as an expression of fluid and electrolyte disturbances in the nervous system

A further decrease in the amount of proteins may, of course, cause the increase of ailments and complications related to the loss of other protein functions (regulatory or building blocks), but it is very rare, because the symptoms of the disease causing hypoproteinemia appear earlier, which force them to intensely treatment of these diseases.

Of course, apart from the symptoms mentioned above, there are also ailments related to the disease causing hypoproteinemia, e.g.

  • chronic diarrhea, nausea, vomiting in protein-losing enteropathy
  • jaundice, mental disorders and bleeding in liver failure
  • haematuria, abdominal pain, sometimes hypertension in kidney diseases

These are just examples of diseases that cause hypoproteinemia (most kidney and liver diseases in advanced stages do) and examples of symptoms they cause, not related to protein loss.

Hypoproteinemia: diagnosis

Hypoproteinemia is foregrounded in blood tests:

  • total protein drop below 60 g / l
  • hypoalbuminemia (albumin concentration below 35 g / l)

In addition, the deficiency of other plasma proteins measured in laboratory tests:

  • gammaglobulin
  • fibrinogen (less than 1.8 g / l)
  • transferrins (less than 25 umol / l)
  • ceruloplasmin (less than 300 umol / l)

The above-mentioned results are a symptom of a deficiency of proteins in the blood.

Due to the mechanisms leading to hypoproteinemia, it is the blood that shows signs of insufficient protein in the body.

This is because protein loss occurs directly from the blood, and when insufficient formation, too few proteins in the body, including plasma proteins, are produced.

In addition, defense mechanisms against hypoproteinemia mean that we mainly lose proteins from the blood, while those structural or storage ones are only in a very advanced state.

It is worth remembering that in the researchlaboratory or imaging, there may also be other abnormalities caused by a disease causing hypoproteinemia.

Diagnostics of the basis of hypoproteins is necessary and necessary to conduct proper therapy, therefore, if it is found, the functioning of the kidneys, liver, gastrointestinal tract and heart should be checked when looking for the cause.

It is also worth remembering that there is a so-calledpseudo-hypoproteinemia , it can lead to misdiagnosis based on laboratory tests.

This happens when the plasma contains more water than normal after administering a large amount of fluids to the patient (orally or through drips), which causes dilution and a drop in protein concentrations. These results can be interpreted as hypoproteinemia, but once the water level in the body has stabilized, the protein levels return to normal.

Hypoproteinemia: treatment

Treatment of protein deficiency requires, first of all, a proper diagnosis - finding the cause of hypoproteinemia, thanks to which it is possible to start the treatment of the disease that led to the protein deficiency.

Unfortunately, it is not always possible, e.g. in advanced liver failure or congenital diseases, the treatment options are very limited.

The protein deficit can be made up to some extent if absorption in the gastrointestinal tract is unaffected, a high-protein diet is used, sometimes with amino acid supplementation, as well as micro- and macronutrients if necessary.

In the case of significant, symptomatic plasma protein deficiencies, some of them can be administered intravenously, e.g. albumin or gamma globulins. It is a quick action, but gives short-term effects, that is, until the given proteins are "consumed" and metabolized.

The ultimate solution is parenteral nutrition, the effects are seen later, but more in the long term. In this case, the diet is selected individually for a particular patient depending on the need for specific amino acids and other nutritional ingredients. The prepared mixtures are fed into large venous vessels.

Both parenteral nutrition and intravenous administration of plasma proteins are most often performed in a hospital setting.

Remember that the most important thing is to treat the cause of hypoproteinaemia (if possible), and that supplementing them is only symptomatic.

If the underlying protein deficiency is not cured, the hypoproteinemia will reappear when protein dosing is discontinued.

Worth knowing

The role of proteins in the body

Proteins are the basis not onlybuilding and functional of our body, they are necessary for its proper functioning, this is due to the multitude of functions that proteins fulfill. Among their numerous tasks, only a few examples are mentioned:

  • enzymatic function - they enable and facilitate many reactions and transformations, they are also substrates and products of numerous metabolic processes
  • storage (e.g. iron - ferritin)
  • regulation of transport through cell membranes, including absorption from the gastrointestinal tract
  • muscle contraction - actin and myosin, the movement of which enables the muscles to function, are proteins
  • regulatory function - some hormones are proteins (e.g. growth hormone or insulin)
  • building material, e.g. collagen

Particularly many of the tasks of pregnancy on plasma proteins, they are responsible, among others, for the transport of substances (hormones, ions or hemoglobin), maintaining a constant blood pH, immunity (antibodies), blood clotting (e.g. fibrinogen) and maintaining fluid inside blood vessels and oncotic pressure.

Oncotic pressure is the pressure necessary to stop the flow of water through biological membranes.

According to the law of osmosis, the flow of the solvent (water) occurs from a lower concentration of a solute to a greater one, so that the concentration on both sides of the membrane is the same.

Under normal conditions (with the appropriate protein concentration), the oncotic pressure is approximately 290 mOsm / l and ensures a balanced water and substance exchange between the intercellular fluid and the plasma.

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