[A child without edema in spite of albumin deficiency]

During extended investigation of a newborn girl with recurrent respiratory tract infection a continuous elevated blood sedimentation rate was noted together with a normal level of C reactive protein. This abnormality could be explained by analbuminaemia, causing a change in concentration of several other proteins such as transferrin. It was striking that this girl without albumin showed no signs of oedema. This lack of oedema could be explained by a decrease of oncotic pressure in the interstitium. Analbuminaemia is an autosomal recessive disorder. At follow-up the girl was still without complaints after 6 years.