From the Guidelines
Patients with severe malnutrition typically show multiple abnormal lab findings, including low serum albumin and total protein levels, electrolyte imbalances, anemia, lymphopenia, and deficiencies in vitamins and minerals, as evidenced by studies such as 1 and 1. When evaluating a patient with severe malnutrition, several key laboratory findings are expected.
- Low serum albumin and total protein levels are common, indicating protein deficiency, as noted in 1.
- Anemia is frequently present, characterized by decreased hemoglobin, hematocrit, and often microcytic or normocytic red blood cells.
- Electrolyte imbalances, including hypokalemia, hypomagnesemia, hypophosphatemia, and hypocalcemia, are also typical, as highlighted in 1.
- Lymphopenia may be observed due to immune system compromise.
- Liver function tests might reveal elevated transaminases, while cholesterol levels are often decreased.
- Blood glucose can be low due to depleted glycogen stores.
- Deficiencies in vitamins and minerals, particularly low levels of vitamin B12, folate, iron, zinc, and fat-soluble vitamins (A, D, E, K), are common, as discussed in 1.
- Prealbumin and transferrin, which are more sensitive markers of recent nutritional status than albumin, would be decreased, as mentioned in 1. These laboratory abnormalities reflect the body's adaptation to starvation, with breakdown of protein stores, impaired organ function, and depletion of essential micronutrients necessary for normal physiological processes, emphasizing the importance of monitoring and addressing these issues to improve patient outcomes, as stressed in 1.
From the Research
Lab Findings in Severe Malnutrition
- Low serum albumin levels: This is due to the regulatory role of albumin in the distribution of body fluids, acid-base physiology, and binding of essential components in the bloodstream 2.
- Elevated C-reactive protein (CRP) levels: CRP is produced by hepatocytes and is commonly used to assess inflammation. Inflammatory conditions, such as those caused by severe malnutrition, tend to increase CRP levels while decreasing albumin levels 2.
- Abnormal white blood cell (WBC) counts: A negative correlation between albumin and WBC levels has been identified, suggesting that severe malnutrition may lead to changes in WBC counts 2.
- Abnormal platelet (PLT) counts: A positive correlation between albumin and platelet levels has been found, indicating that severe malnutrition may affect platelet counts 2.
- Low hemoglobin levels: A positive correlation between albumin and hemoglobin levels has been identified, suggesting that severe malnutrition may lead to anemia 2.
Additional Lab Findings
- Electrolyte imbalances: Severe malnutrition can lead to electrolyte imbalances, particularly in potassium, sodium, and magnesium levels.
- Abnormal liver function tests: Severe malnutrition can affect liver function, leading to changes in liver enzyme levels.
- Low blood glucose levels: Severe malnutrition can lead to hypoglycemia due to inadequate nutrient intake.