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Differential Diagnosis: Hypoalbuminemia

Julie Allen, BVMS, MS, MRCVS, DACVIM (SAIM), DACVP (Clinical), Durham, North Carolina

Internal Medicine

|April 2019|Peer Reviewed

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Following are differential diagnoses, listed in order of likelihood, for patients presented with hypoalbuminemia.

  • Increased loss
    • Protein-losing nephropathy (eg, glomerulonephritis, Lyme nephritis)
    • Protein-losing enteropathy (eg, inflammatory bowel disease, lymphangiectasia)
    • Hemorrhage
    • Severe exudative dermatitis (eg, large burns or wounds, snakebites)
  • Decreased production
    • Acute phase reaction (albumin is a negative acute phase protein)
    • Liver dysfunction/failure
    • Secondary to hyperglobulinemia (ie, albumin is downregulated due to increased oncotic pressure from increased globulins)
    • Starvation (ie, chronic, severe malnutrition)
  • Excessive fluids (dilutional effect)
  • Hypoadrenocorticism
  • Sequestration (eg, secondary to loss in protein-rich effusions), third-spacing
  • Hemophagocytic histiocytic sarcoma
  • Increased catabolism (poorly characterized)


For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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