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Albumin is the most abundant serum protein. It has a

molecular weight of 65,000 and consists of 584
amino acids and contains no carbohydrate. Albumin
is produced exclusively in the liver and secreted
directly into the circulation. Physiological roles
includes maintenance of oncotic pressure (albumin
provides 80% of the plasma oncotic pressure), and
transport of small molecules such as calcium,
unconjugated bilirubin, free fatty acids, cortisol and
thyroxine. Albumin also binds drugs in the serum, eg
warfarin, phenylbutazone and clofibrate.
The half-life of albumin in the circulation is about 20
days and the liver has large reserves of albumin
synthetic capacity. Although albumin is the most
abundant serum protein, it contributes little to the
osmolality as the concentration is about 0.6 mmol/L
when expressed in SI units.
Serum albumin is a useful marker of chronic liver
disease
and
nutritional
status,
although
consideration must be given to other factors
contributing to the level.
High albumin concentrations in plasma

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Elevated concentrations of albumin in plasma are
caused by a relative loss of water. This occurs in
dehydration, or with prolonged use of a tourniquet.
There are no pathological conditions other than
dehydration associated with a high albumin
concentration. Note however that elevated albumin
may indicate artefactual elevation of other analytes
such as haemoglobin, lipids and calcium.
Low albumin concentrations in plasma

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Causes of low plasma albumin
Low concentrations of serum albumin may be caused
by
artefact,
decreased
albumin
production,
increased loss, or redistribution in the body.
Artefact: usually due to drip-arm contamination of

the sample.
Decreased production: malnutrition, malabsorption,

chronic liver disease (eg cirrhosis) or the acute
phase response.
Increased loss: protein-losing states (nephrotic

syndrome, protein-losing enteropathy), severe
burns, during operative procedures.
Redistribution: during sepsis albumin may be lost

into the extravascular compartment due to
increased vascular permeability, in ascites due
to an exudate albumin is lost into the abdominal
cavity.
Note that low serum albumin does not occur in

uncomplicated acute viral hepatitis, and a normal
serum albumin makes the diagnosis of cirrhosis
unlikely.
Effects of low plasma albumin
The effects of low plasma albumin are mainly related
to maintenance of fluid in the circulating
compartment. With reduced levels of serum albumin
fluid may escape into tissues to cause oedema or

into body cavities to cause ascites or pleural
effusions. Extremely low albumin may also affect the
delivery of nutrients to tissues by the formation of
localised tissue oedema. Reduced or increased levels
of albumin in a sample will affect the measurement
of total serum calcium, with low albumin producing a
low serum total calcium (and vice versa) These
conditions do not indicate a disorder of calcium
metabolism.
Indications for Measurement (top of page)

Albumin should be measured whenever liver disease
is suspected, in cases of oedema, if malnutrition or
malabsorption is suspected, or if a protein-losing
state
(nephrotic
syndrome,
protein-losing
enteropathy or burns) is suspected. Albumin can be
a useful monitor of these conditions but repeat
measurements at intervals of less than 1 week are
rarely indicated and longer intervals are appropriate
in non-acute cases.
Albumin should also be measured whenever a total
serum calcium is requested.
Albumin Measurement (top of page)

Plasma albumin is a component of the Liver Function
Tests (LFTs) but may be ordered separately.Albumin
can be measured in Serum (gold -top) or heparin
plasma (Lime top).The reference interval is 36 - 47
g/L.The method used at SydPath is Bromocresol
green on an Hitachi 917 or 747 analyser.The test is
performed 7 days/24 hours and results are available
within 2 hours of the sample arriving in the
laboratory.
Optimal Range: 2.3-2.8 g/dL

Optimal Range (Alpha Globulin): 0.2-0.3 g/L
Optimal Range (Beta Globulin): 0.7-1.0 g/L
The globulin level may be elevated in:
Chronic infections (parasites, some cases of viral
and bacterial infection)
Liver disease (biliary cirrhosis, obstructive jaundice)
Carcinoid syndrome
Rheumatoid arthritis
Ulcerative colitis
Multiple myelomas, leukemias, Waldenstrom's
macroglobulinemia
Autoimmunity (Systemic lupus, collagen diseases
Kidney dysfunction (Nephrosis)
The serum globulin level may be decreased in:
Nephrosis (A Condition in which the kidney does not

filter the protein from the blood and it leaks into
the urine)
Alpha-1 Antitrypsin Deficiency (Emphysema)
Acute hemolytic anemia
Liver dysfunction
Hypogammaglobulinemia/Agammaglobulinemia
Fibrinogen alpha chain is a protein that in humans is encoded by the
FGA gene.
The protein encoded by this gene is the alpha component of fibrinogen, a
blood-borne glycoprotein composed of three pairs of nonidentical
polypeptide chains. Following vascular injury, fibrinogen is cleaved by
thrombin to form fibrin which is the most abundant component of blood
clots. In addition, various cleavage products of fibrinogen and fibrin
regulate cell adhesion and spreading, display vasoconstrictor and
chemotactic activities, and are mitogens for several cell types. Mutations in
this gene lead to several disorders, including dysfibrinogenemia,
hypofibrinogenemia, afibrinogenemia and renal amyloidosis. Alternative
splicing results in two isoforms which vary in the carboxy-terminus.[1]

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eneral (top of page)

Albumin is the most abundant serum protein. It has a

High albumin concentrations in plasma

such as haemoglobin, lipids and calcium.

Low albumin concentrations in plasma

Artefact: usually due to drip-arm contamination of

Decreased production: malnutrition, malabsorption,

Increased loss: protein-losing states (nephrotic

Redistribution: during sepsis albumin may be lost

Note that low serum albumin does not occur in

fluid may escape into tissues to cause oedema or

Indications for Measurement (top of page)

Albumin Measurement (top of page)

Optimal Range: 2.3-2.8 g/dL

Nephrosis (A Condition in which the kidney does not

Fibrinogen alpha chain is a protein that in humans is encoded by the

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