EDEMA WITH UNEXPLAINED HYPOPROTEINEMIA

Abstract

Until lately the state of hypoproteinemia has been explained as the consequence either of loss of body protein, such as occurs in nephritis, or of the lack of dietary protein. Recently Bloomfield,¹ Melnick and Cowgill² and others have shown the inadequacy of this "loss and lack" theory and have pointed to defective formation of serum proteins as a factor in the reduction of serum protein concentration. Some of the evidence favoring the hepatic origin³ of the plasma proteins derives from reported cases⁴ of hepatic disease with hypoproteinemia apparently due to defective protein formation (without loss of ascitic fluid). In cases of nephritis such impairment of protein formation is more difficult to demonstrate, even though the serum protein concentration may decline in some patients who lose only a few grams of protein in the urine, while in other patients (and in rats after subtotal nephrectomy⁵) relatively