Total Protein (serum)

General Information

Total protein measurements are used in a variety of clinical situations. It may be used in combination with albumin measurements to identify a range of disorders. In the clinical states which follow, the diseases listed are total protein may be increased or decreased as indicated, but not in all patients presenting with the disorders. Causes of high total protein: dehydration; some cases of chronic liver disease, including chronic active hepatitis and cirrhosis; neoplasms, especially myeloma; macroglobulinemia of Waldenström; tropical diseases (eg, kala-azar, leprosy, and others); granulomatous diseases, such as sarcoidosis; diseases in which total protein is sometimes high include collagen disease (eg, lupus erythematosus (SLE), and other instances of chronic infection/inflammation). Causes of low total protein: pregnancy; intravenous fluids; cirrhosis or other liver disease, including chronic alcoholism; prolonged immobilization; heart failure; nephrotic syndromes; glomerulonephritis; neoplasia; protein losing enteropathies; Crohn disease and chronic ulcerative colitis; starvation, malabsorption or malnutrition; hyperthyroidism; burns; severe skin disease; and other chronic diseases. Very low total protein (<40 g/L) and low albumin cause oedema (eg, the nephrotic syndromes).