ALB and anemia: Nonetheless, the absence of feeding problems, discernible GI (normal and regular bowel movements, negative stool culture, and normal ultrasound) or liver pathology (no jaundice, normal liver enzymes, and only borderline low albumin), and lack of ketones in urine, along with a normal MCV, rule out nutritional deficiency or underfeeding as the likely etiologies of her severe anemia.