Differential Diagnosis: Hypoalbuminemia

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

ArticleLast Updated April 20191 min readPeer 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)