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Total serum protein is the sum of the concentration of the circulating proteins. Changes in total protein concentration may reflect changes in one, several or all fractions. The clinical significance of a change in total protein is difficult to interpret without knowledge of the level of the individual protein fractions, as determined by serum protein electrophoresis. Causes of increased total protein include chronic infection, liver disease, autoimmune disease, sarcoidosis, monoclonal gammopathies, dehydration, and hemolysis. Total protein is decreased in malnutrition, liver disease, renal disease, nephrotic syndrome, malabsorption, protein losing enteropathy, exfoliative dermatitis, burns, hypogammaglobulinemia, IV fluids, and pregnancy. Total serum protein level is higher in ambulatory than recumbent patients. Reference range is 6.5 - 8.2 gm/dL.
