No Serum Albumin in Myeloma-Reply

Yi-Hsiang Chen, MD
Arch Intern Med. 1991;151(3):618-619. doi:10.1001/archinte.1991.00400030144036.
Text Size: A A A
Published online

In Reply.—  Dr Rubinstein proposed several possible pathogenetic mechanisms for hypoalbuminemia associated with multiple myeloma that we have recently described.1 Some of these mechanisms have already been discussed in our article. We would like to elaborate on the following points:

  1. Agreeing with Rubinstein, we also feel that hypoalbuminemia is likely a part of the cachexia syndrome associated with neoplasia. It, however, merits reemphasizing, as we did in our article, that cachexia is not simply the result of inadequate nutritional intake in patients with cancer, but may represent a set of characteristic biochemical and metabolic changes,2 possibly mediated by various tumor- and/or host-derived cytokines. We have mentioned specific suppression of hepatocyte albumin gene expression by interleukin 1. Other cytokines, such as tumor necrosis factor α/cachectin33 and interleukin 6,4 may also act additively or synergistically. Thus, correction of nutritional deficiency or supplementation with excess calorie and protein by hyperalimentation is


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.