Acquired bisalbuminemia associated with hepatobiliary disease: a two-case report and diagnostic implications.

INTRODUCTION

Acquired bisalbuminemia is an uncommon qualitative albumin abnormality increasingly detected by capillary electrophoresis. It can be associated with several pathologic contexts.

METHODS

A retrospective analysis was performed on two cases of bisalbuminemia detected over a 10-year period in the biochemistry-toxicology laboratory of Moulay Ismail Military Hospital in Meknes, Morocco. Clinical, biochemical, electrophoretic, and histologic data were reviewed, with particular emphasis on serum albumin electrophoretic patterns.

RESULTS

Bisalbuminemia was identified in two distinct hepatobiliary contexts: an overlap syndrome between autoimmune hepatitis and primary sclerosing cholangitis and antibiotic exposure in a patient with cholangiocarcinoma. In both cases, the abnormal albumin fraction was temporary and resolved after treating the underlying condition or withdrawing the drug that was causing it.

DISCUSSION: Acquired bisalbuminemia represents a reversible laboratory finding that reflects underlying pathologic or pharmacologic processes. Capillary electrophoresis plays a pivotal role in the detection and follow-up of this condition.