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Indian Journal of Medical Sciences, Vol. 61, No. 6, June, 2007, pp. 356-357 Letter To Editor Bisalbuminemia in an adult male with Alzheimer's disease Shetty JeevanK, Prakash Mungli, Gopalakrishna Kodyalamoole Department of Biochemistry, Kasturba Medical College, Manipal, Karnataka Code Number: ms07057 Editor, A 72-year-old male was admitted to the department of neurology complaining of altered sensorium, delirium and hallucinations for the preceding 5 days prior to admission. He had a history of memory disturbances since 6 months. On examination, the patient was conscious, vitals were stable and orientation to person and place, but not to time, was present. Conscious levels were fluctuating following admission with sun downing present. On neurological examination, no abnormality was noticed. The patient was investigated by relevant biochemical tests and was found to be normal except for two bands in the region of albumin in serum agarose gel electrophoresis [Figure - 1]. Chest x-ray and 2-D echocardiogram were normal, but CT scan showed diffuse cerebral and cerebellar atrophic changes. Based on history, examination and radiological findings, the patient was diagnosed as Alzheimer′s disease. Bisalbuminemia is a rarely encountered anomaly characterized by splitting of the serum albumin into two components of which one represents a variant on account of genetically inherited or acquired determinant. [1] Serum electrophoresis reveals two bands of albumin; the mobility of variant band is faster for the acquired form. [2],[3] Bisalbuminemia is generally not associated with any specifically recognized disease entity. [1] Compared to Western data, bisalbuminemia in the Indian population has not been a frequent finding, as only few cases have been reported till date. [1],[4] Inheritance of bisalbuminemia has been reported to show no pathological or therapeutic consequences. [2] Cases of acquired bisalbuminemia have been reported in several disease conditions, including multiple myeloma and nephrotic syndrome. [2],[5] Worldwide cumulative frequency of bisalbuminemia was reported to be 1:10,000 to 1:1,000, [2] but Dash et al. have shown that prevalence rate of bisalbuminemia in Punjab is approximately 2:1,000. [4] To the best of our knowledge, bisalbuminemia in Alzheimer′s disease has not been reported till date. The cause of bisalbuminemia in our case may be incidental finding on serum agarose gel electrophoresis, or it may be associated with certain acquired genetic abnormalities associated with Alzheimer′s disease; but at present, it is difficult to make a comment on such finding of bisalbuminemia in Alzheimer′s disease. We recommend further observation of serum electrophoretic bands for repetition of such finding in Alzheimer′s disease and to look for the cause and consequences of such findings. References
Copyright 2007 - Indian Journal of Medical Sciences The following images related to this document are available:Photo images[ms07057f1.jpg] |
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