Bisalbuminemia from a clinical chemist's viewpoint: a case report and review of the recent literature

Abstract

Bisalbuminemia is a rare inherent or acquired abnormality characterized by the occurrence of 2 distinct albumin bands or a single widened albumin band, after electrophoretic screening of blood proteins. Despite the fact that the presence of 2 albumin bands in electrophoresis, representing normal and variant protein, is observed with a frequency of 0.00030.0010 in the average population, its role in various pathological states has not yet been clearly defined. Until now, the only disorders which have been directly linked with the presence of congenital bisalbuminemia are familial dysalbuminemic hyperthyroxinemia (Arg218AEHis and Arg218AE Pro mutations) and hypertriiodothyroninemia (Leu66AEPro mutation), while acquired types of bisalbuminemia have been reported after an overdose of beta-lactam antibiotics and as a consequence of severe pancreatitis. We present a case of bisalbuminemia in an adult man who was referred to our laboratory with a prolonged history of recurrent abdominal pain and review the recent literature in order to better familiarize clinicians as well as laboratory personnel with this entity. The biochemical parameters assessed did not show any alteration which could correlate the protein disorder with any distinct pathology.