Hypoalbuminemia Clinical Presentation

Updated: Sep 11, 2020
  • Author: Ruben Peralta, MD, FACS, FCCM, FCCP; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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The potential underlying causes of hypoalbuminemia are numerous. Patients' histories vary significantly depending on the underlying disease state.

Gather past medical history for a history of liver or renal failure, hypothyroidism, malignancy, and malabsorption. Evaluate the patient for appropriate dietary intake. Seek potential causes of acute or chronic inflammation that could explain the low albumin levels.


Physical Examination

Abnormal physical examination findings may be found in multiple organ systems depending on the underlying disease. The following findings suggest the potential underlying disease processes rather than the underlying hypoalbuminemia, per se:

  • Head, eyes, ears, nose, and throat - Facial edema, macroglossia, parotid swelling, conjunctival icterus, temporal wasting

  • Integumentary - Loss of subcutaneous fat, delayed wound healing, dry coarse skin, painful dermatoses, peripheral edema, thin hair, spider angiomas, palmar erythema, changes due to surgery and burns, jaundice

  • Cardiovascular - Bradycardia, hypotension, cardiomegaly

  • Respiratory - Decreased respiratory expansion due to pleural effusion and weakened intercostal muscles

  • Gastrointestinal - Hepatosplenomegaly, ascites

  • Musculoskeletal - Muscle wasting, growth retardation in children, atrophy of the interosseus hand muscles

  • Neurological - Encephalopathy, asterixis

  • Genitourinary - Testicular atrophy

  • Endocrine - Gynecomastia, hypothermia, thyromegaly

  • Other - Various other signs related to associated specific nutrient deficiencies