Hypoalbuminemia

Introduction Protein malnutrition is also known as edematous malnutrition or hypoproteinemia. Protein is the basic component of the body's tissue cells, and all tissue cells in the human body contain proteins. The growth and development of the body, the renewal of aging cells, and the repair of tissue damage are inseparable from protein. Protein is also an indispensable ingredient in enzymes, hormones and antibodies. Since the protein is a zwitterion, it has a buffering effect. Protein is also a determinant of water retention and control of water distribution, and is one of the sources of heat. 1g of protein can produce 16.6 kilojoules of heat in the body. For example, children's protein deficiency is not only affecting their physical development and mental development, but also causes the entire physiology to be in an abnormal state, with low immune function and reduced resistance to infectious diseases.

Cause

The cause has not been determined. It was first reported by Africa. Although it is found globally, it is more common in some developing countries in the tropics and subtropics. The pathogenesis seems to be due to the lack of aromatic amino acids or the lack of protein in the diet, resulting in the loss of enzyme activity and the onset.

an examination

Related inspection

Urinary albumin clearance rate serum sialic acid determination

According to the patient's symptoms and signs: edema in the face and feet of children between 6 months and 5 years old, and even spread throughout the body. White-skinned children have specific skin lesions, starting with erythema, the pressure can subside, followed by small dark purple spots, clear borders, higher than the surrounding skin, the pressure does not fade, the surface is bright, and there is a waxy feeling. It turns into a dry, brown or black spot with cracks. Occurs in the compression parts, such as trochanter, knee, ankle, shoulder, elbow and torso pressure, can also occur in wet areas, such as diaper area, irregularly clothed throughout the body, showing exfoliative dermatitis. In mild cases, cracks (called "mosaic" skin) and desquamation along the tangential line of the skin appear only in front of the ankle, outside the thigh, and at the back. Severe cases have large areas of erosion and epidermal loss, leaving pigmentation after the healing, especially in the forehead, buttocks, appendix and foot. It becomes pale due to thinning of the skin, swelling, and hypopigmentation. It is often caused by patients with dark-skinned races. It usually begins in the mouth and can also be located in the lower leg. It can also be decolored after rubbing, trauma and ulceration. Occasionally, bullae, or shallow or deep ulcers and necrosis are formed in the back of the foot, the buttocks, and the parts unrelated to the pressure. Occasionally, on the back, lower abdomen and lower limbs. In advanced cases, linear splits occur around the auricle, on the knees, in front of the elbows, between the toes, between the toes, in the foreskin and in the middle of the lips. Plasma total protein can be detected.

Differential diagnosis

Hypoproteinemia needs to be identified as follows:

1 protein intake is insufficient or poorly absorbed. Loss of appetite and anorexia caused by various reasons, such as severe heart, lung, liver, kidney disease, gastrointestinal congestion, brain lesions, digestive tract obstruction, difficulty in feeding such as esophageal cancer, gastric cancer; chronic pancreatitis, biliary tract disease, Malabsorption syndrome caused by gastrointestinal anastomosis.

2 protein synthesis disorders. Liver damage for various reasons reduces liver protein synthesis and decreases plasma protein synthesis.

3 long-term loss of large amounts of protein. Gastrointestinal ulcers, acne, hookworm disease, menorrhagia, large-scale wound exudate can cause a large amount of plasma protein loss. Repeated abdominal puncture drainage, end-stage renal disease peritoneal dialysis treatment can lose protein through the peritoneum. Nephrotic syndrome, lupus nephritis, malignant hypertension, diabetic nephropathy, etc. may have a large amount of proteinuria, and proteins are lost from the urine. Digestive tract malignant tumors and giant hypertrophic gastritis, protein leakage gastrointestinal disease, ulcerative colitis, localized enteritis, etc. can also lose a large amount of protein from the digestive tract.

4 protein decomposition accelerates. Long-term fever, malignant tumors, hypercortisolism, hyperthyroidism, etc., cause protein breakdown beyond synthesis, leading to hypoproteinemia.

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