Ejaz A Ahsan, Krishna Murli, Wasiluk Andrew, Knight Janice D
Division of Nephrology and Hypertension, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Clin Exp Nephrol. 2004 Sep;8(3):270-3. doi: 10.1007/s10157-004-0291-1.
Hereditary and acquired bisalbuminemia, in which the serum contains an albumin variant differing from albumin A by single amino-acid substitutions, have been reported in different races or ethnic groups and in association with various pathologic states. The importance of this rare condition in the pathophysiology of established diseases is uncertain. We evaluated a 68-year-old woman with chronic kidney disease who presented with worsened serum creatinine concentration despite lack of dietary or medical changes. Serum protein electrophoresis was performed with an automated rapid electrophoresis system. Bisalbuminemia was noted as an incidental finding on serum protein electrophoresis. The serum creatinine level stabilized with dietary protein restriction and a beta-blocking agent/diuretic combination for blood pressure control. Although the possibility that some physiologic or pharmacologic substances may not bind to abnormal albumin variants as well as they bind to normal albumin should not be discounted, the finding of bisalbuminemia did not influence the diagnosis, management, course, or prognosis of chronic kidney disease. The role of persistent bisalbuminemia in renal disease is uncertain.
遗传性和获得性双白蛋白血症患者的血清中含有一种白蛋白变体，该变体与白蛋白A存在单个氨基酸替换的差异，不同种族或民族以及与各种病理状态相关的此类病例均有报道。这种罕见病症在已确诊疾病的病理生理学中的重要性尚不确定。我们评估了一名68岁患有慢性肾脏病的女性，尽管饮食或药物治疗未改变，但她的血清肌酐浓度仍升高。使用自动快速电泳系统进行血清蛋白电泳。血清蛋白电泳时偶然发现了双白蛋白血症。通过限制饮食蛋白质以及使用β受体阻滞剂/利尿剂联合控制血压后，血清肌酐水平稳定。尽管不能排除某些生理或药理物质与异常白蛋白变体结合的能力不如与正常白蛋白结合的可能性，但双白蛋白血症的发现并未影响慢性肾脏病的诊断、治疗、病程或预后。持续性双白蛋白血症在肾脏疾病中的作用尚不确定。
