Resolving the Baneful and Banal: Bisalbuminemia in an Adult With Waldenström Macroglobulinemia

Mark Valasek; Richard Hopley; Frank Wians
December 2008
Laboratory Medicine;Dec2008, Vol. 39 Issue 12, p723
Academic Journal
Case reports of bisalbuminemia (patient serum containing albumin A and an albumin variant differing by single amino-acid substitutions) have included different races or ethnic groups and are often reported in association with various pathologic states. Here, we describe a 70-year-old woman with vague symptoms, the most concerning of which was worsening vision with retinal hemorrhages found on exam. During the workup, serum protein electrophoresis was performed demonstrating a prominent monoclonal component (IgM kappa) and bisalbuminemia as an incidental finding. This represents the first reported case in the literature of the coexistence of bisalbuminemia and Waldenström macroglobulinemia. The possibility exists that some endogenous or pharmacologic substances may interact differently with albumin variants as compared with normal albumin; however, the finding of bisalbuminemia did not influence the diagnosis, management, course, or prognosis of this patient's lymphoma.


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