Question
Which one of the following serum proteins does not decrease in nephrotic syndrome?
| A. | Albumin |
| B. | Transferrin |
| C. |
Fibrinogen |
| D. |
Ceruloplasmin |
|
Correct Answer � C Explanation |
 |
Nephrotic syndrome is characterized by:
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Heavy proteinuria (>3.5 g/day),
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Hypoalbuminemia,
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Edema,
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Hyperlipidemia,
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And lipiduria.
As a result of increased glomerular permeability, many plasma proteins are lost in the urine. However, the liver compensates by increasing the synthesis of certain proteins—especially those involved in coagulation and acute phase response.
Evaluation of Each Option:
A. Albumin – Decreases in nephrotic syndrome
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Major plasma protein lost in urine due to its small molecular size.
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Its loss is primarily responsible for the hypoalbuminemia and edema seen in nephrotic syndrome.
B. Transferrin – Decreases in nephrotic syndrome
-
A smaller globulin protein responsible for iron transport.
-
Lost in the urine along with other low molecular weight proteins.
C. Fibrinogen – Does not decrease; rather, it increases
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It is a large acute-phase protein synthesized by the liver.
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Not readily filtered by the damaged glomeruli due to its large size.
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In fact, its levels may increase as part of the hepatic compensation and acute phase response.
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Elevated fibrinogen contributes to the hypercoagulable state seen in nephrotic syndrome.
D. Ceruloplasmin – Decreases
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A copper-carrying alpha-2 globulin with moderate molecular weight.
-
May be lost in the urine, though not as extensively as albumin or transferrin.
