Abstract
Bisalbuminemia is an uncommon finding that is seen as bifid albumin peak on serum protein electrophoresis. We report here this unusual finding in an adult male diagnosed with multiple myeloma on routine workup.
Keywords: Electrophoresis, Myeloma, Albumin
Bisalbuminemia is an uncommon disorder characterised by bifid albumin peak on serum protein electrophoresis. The disorder can be inherited or acquired and is very rare in Indian population. When inherited it follows an autosomal dominant pattern [1, 2]. The acquired form of the disease is seen in patients taking ß lactam antibiotics, pancreatic pseudocyst rupture, diabetes mellitus, cirrhosis, hyperamylasemia, nephrotic syndrome, sarcoidosis, Alzheimer’s disease and plasma cell dyscrasia [3, 4]. There is no known clinical significance of this finding, although it should be kept in mind and not misinterpreted as an abnormal globulin peak specifically when dealing with suspected or confirmed cases of plasma cell dyscrasia. The case described here is of a 67-year-old female with multiple myeloma who was consolidated with auto-HSCT outside. The patient came to our centre for follow-up and showed this finding on workup (Fig. 1). The diagnostic electrophoresis was not available to comment on hereditary or acquired nature of the disease. The patient had no other comorbidities (described above) which may be attributed to this disorder.
Fig. 1.
Serum protein electrophoresis showing bifid albumin peak
Funding information
The study is the retrospective analysis of the data of patient at the Rajiv Gandhi Cancer Hospital and Research Institute. No funding received.
Compliance with Ethical Standards
Conflict of interest
The authors declares that they have no conflict of interest.
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References
- 1.Kalambokis G, Kitsanou M, Kalogera C, Kolios G, Seferiadis K, Tsianos E. Inherited bisalbuminemia with benign monoclonal gammopathy detected by capillary but not agarose gel electrophoresis. Clin Chem. 2002;48(11):2076–2077. [PubMed] [Google Scholar]
- 2.Ejaz AA, Krishna M, Wasiluk A, Knight JD. Bisalbuminemia in chronic kidney disease. Clin Exp Nephrol. 2004;8(3):270–273. doi: 10.1007/s10157-004-0291-1. [DOI] [PubMed] [Google Scholar]
- 3.Angouridaki C, Papageorgiou V, Tsavdaridou V, Giannousis M, Alexiou-Daniel S. Detection of hereditary bisalbuminemia in a Greek family by capillary zone electrophoresis. Hippokratia. 2008;12(2):119–121. [PMC free article] [PubMed] [Google Scholar]
- 4.Chhabra S, Bansal F, Saikia B, Minz RW. Bisalbuminemia: a rarely encountered protein anomaly. J Lab Physicians. 2013;5(2):145–146. doi: 10.4103/0974-2727.119869. [DOI] [PMC free article] [PubMed] [Google Scholar]