Which bloodwork finding is commonly seen in PLE?

• A. Low globulins
• B. Low calcium
• C. Low cholesterol
• D. Low albumin

Answer: (D)

Protein-losing enteropathy causes loss of proteins through the gut, so the most common bloodwork finding is a drop in albumin. Albumin is the largest fraction of plasma protein and chiefly maintains oncotic pressure; when it’s lost into the intestinal lumen, serum albumin falls. You may also see lower globulins in some cases because immunoglobulins can be lost as well, but the hallmark and most reliable indicator is hypoalbuminemia. Note that total calcium can appear low if albumin is reduced, since calcium binds to albumin, though the physiologically active ionized calcium may stay normal. Cholesterol isn’t the defining feature of PLE.