Exploring the Link between Diabetes and Acquired Bisalbuminemia: Case Reports and Literature Review

Abstract

Bisalbuminemia, characterised by the division of the albumin fraction on serum protein electrophoresis without an increase in concentration, is a rare protein anomaly that can present as either congenital or acquired. While congenital bisalbuminemia has a genetic basis, acquired bisalbuminemia is often associated with various underlying conditions, including excessive use of beta- lactam antibiotics, pancreatic fistula, and certain monoclonal immunoglobulins. Recent interest has emerged regarding the potential relationship between bisalbuminemia and diabetes mellitus. This study aims to explore the role of diabetes in acquired bisalbuminemia through the presentation of two cases and a review of relevant literature. Case 1 describes a 68-year-old female with recurrent pneumorespiratory infections, leading to the discovery of bisalbuminemia and subsequent diagnosis of diabetes mellitus. Case 2 involves a 71-year-old patient presenting with worsening lower back pain and bisalbuminemia, ultimately leading to a diagnosis of diabetes mellitus. Discussion highlights the significance of diabetes as a potential contributing factor to acquired bisalbuminemia, as suggested by previous case reports and prospective studies. While further research with larger cohorts is needed to confirm these findings, the inclusion of diabetes biological workup in bisalbuminemia cases may aid in early detection and management. In conclusion, this study underscores the potential association between uncontrolled diabetes and acquired bisalbuminemia, suggesting the importance of assessing for diabetes in such cases to improve diagnostic approaches for this rare condition.