Bisalbuminemia: An Uncommon Finding on Serum Electrophoresis

Abstract

Bisalbuminemia is a rare finding, characterised by the presence of two albumin fraction on serum protein electrophoresis. The disorder can either be inherited in autosomal dominant pattern or acquired. Acquired bisalbuminemia have discovered in various pathological conditions like diabetes mellitus, multiple myeloma, alzheimer’s disorder, sarcoidosis, nephrotic syndrome, chronic kidney disease, pancreatic pseudocyst and in patient receiving high doses of penicillin. Hereby, authors reports an uncommon case of a 55-years-old male, who presented with symptoms of lower back pain since 4 month. X-ray skull shows multiple lytic lesions. Bone marrow aspirate was hypercellular and showed 60% plasma cells. Patient was diagnosed with multiple myeloma and was sent for further biochemical investigations. Serum protein electrophoresis showed two distinct bands in the albumin region and a prominent M peak in gamma globulin region. The band may be mistaken as an abnormal globulin peak specifically while screening suspected or confirmed cases of monoclonal gammopathies.