Acute Appendicitis in Pregnancy

Abstract

The extreme degrees of oedema seen in some of the patients (especially the children with glomerulonephritis) were thought to be associated with gross hypoalbuminaemia. The cause of this was partly albuminuria, which was usually heavy (in one child, loss of urinary protein reached a level of 22 g./litre at a time when the serum albumin level was 0.49%). In some patipnts the serum albumin level continued to fall after admission to hospital, presumably because the patients were admitted early in the course of their illness before the drain of albumin in their urine had fully depleted the serum protein level. Another factor in the development of gross oedema may have been that the serum protein levels of even apparently healthy Africans in Uganda are different from European normals (Holmes, Stanier, Semambo, and Jones, 1951), the albumin levels being lower and the globulin levels higher than in Europeans. The serum albumin levels in these patients, especially in the children, were therefore probably low before the urinary loss began.