TP – Overview: Protein, Total, Serum

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

Plasma proteins are synthesized predominantly in the liver;

immunoglobulins are synthesized by mononuclear cells of lymph

nodes, spleen and bone marrow. The 2 general causes of alterations

of serum total protein are a change in the volume of plasma water

and a change in the concentration of 1 or more of the specific

proteins in the plasma. Of the individual serum proteins, albumin is

present in such high concentrations that low levels of this protein alone

may cause hypoproteinemia.

Hemoconcentration (decrease in the volume of plasma water) results in

relative hyperproteinemia; hemodilution results in relative

hypoproteinemia. In both situations, concentrations of all the individual

plasma proteins are affected to the same degree.

Hyperproteinemia may be seen in dehydration due to inadequate water

intake or to excessive water loss (eg, severe vomiting, diarrhea, Addison disease, and diabetic acidosis) or as a result of increased production

of proteins. Increased polyclonal protein production is seen in reactive,

inflammatory processes; increased monoclonal protein production is seen

in some hematopoietic neoplasms (eg, multiple myeloma, Waldenstrom macroglobulinemia, monoclonal gammopathy of undetermined

significance).