Protein (Total), Serum

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Subject: Protein (Total), Serum

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Definition

  • Total serum protein is the sum of the concentration of the circulating proteins. A total serum protein test is a blood test that measures the amounts of total protein, albumin, and globulin in the blood. The amounts of albumin and globulin also are compared (albumin/globulin ratio). Normally, there is a little more albumin than globulin, and the ratio is >1. A ratio <1 or much >1 can give clues about problems in the body.

  • Normal range:

    • 0–7 days: 4.6–7.0 g/dL

    • 7 days–1 year: 4.4–7.5 g/dL

    • 1–3 years: 5.5–7.5 g/dL

    • 3 years to adult: 6.0–8.0 g/dL

Use

  • Diagnosis and treatment of diseases involving the liver, kidney, or bone marrow, as well as other metabolic or nutritional disorders

  • Screening for nutritional deficiencies and gammopathies

Interpretation

Increased In

  • Hypergammaglobulinemias (monoclonal or polyclonal; see following sections)

  • Hypovolemic states

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

 
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