I suppose in the one year since the discovery of severe hypoalbuminaemia
the patient has been investigated for all the common causes of
hypoalbuminaemia and they've all been excluded. Just a thought: we've had,
on more than one occasion, analbuminaemic patients. If the patient is
absolutely well, he might be either a heterozygote or one of the homozygote
types with low penetrance of the disease. Worth checking the
lipids. There is lipodystrophy in homozygotes.
Best wishes,
Reza
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