ABSENCE OF SERUM ALBUMIN ASSOCIATED WITH RHEUMATOID ARTHRITIS

Abstract

In routine paper electrophoretic studies of sera with abnormal albumin, globulin ratios led to the discovery of an individual who nearly completely lacked serum albumin. This patient, a 61-year-old negro male, suffered from severe rheumatoid arthritis and rheumatic heart disease in addition to the analbumlnemia. For over 3 years, the serum of this individual had never contained more than a trace of albumin (0-0.09 g/100 ml) as indicated by paper electrophoresis. These low levels were verified by immunochemical determinations of albumin. Elevations of serum glycoproteins and seromucoid were noted similar to those found in severe rheumatoid arthritis. Usual liver function tests were normal. After the administration of human albumin, no albumin was found in the urine, and serum albumin as determined by paper electrophoresis gradually decreased to barely detectable levels. It was concluded that this individual was devoid of the enzyme systems required to synthesize serum albumin.