Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1174 page)

Decreased In

   Nutritional deficiency (e.g., malabsorption, Kwashiorkor, marasmus)

   Decreased or ineffective protein synthesis (e.g., severe liver disease, agammaglobulinemia)

   Increased loss

   Renal (e.g., nephrotic syndrome)

   GI disease (e.g., protein-losing enteropathies, surgical resection)

   Severe skin disease (e.g., burns, pemphigus vulgaris, eczema)

   Blood loss, plasmapheresis

   Increased catabolism (e.g., fever, inflammation, hyperthyroidism, malignancy, chronic diseases)

   Dilutional (e.g., IV fluids, SIADH, water intoxication)

   Third trimester of pregnancy

   Limitations

   Falsely elevated proteins (pseudohyperproteinemia) can be caused by hemoconcentration due to dehydration or sample desiccation.

   Upright posture for several hours after rising increases total proteins and several other analytes