A CASE OF IDIOPATHIC HYPOALBUMINEMIA TURNED AS MYELOMONOCYTIC LEUKEMIA

Hypoalbuminemia is a common cause of generalized edema. Although the underlying cause can usually be identified but very rarely we may come across a case with no detectable cause either clinically or by routine investigations. These cases may be labeled as having idiopathic hypoalbuminemia. These are challenging cases for diagnosis and usually lead to treatment errors exposing the patient to side-effects of unnecessary medications. We present an adult patient with idiopathic hypoalbuminemia who presented with generalized edema and had no evidence of renal, hepatic, cardiac, or thyroid abnormality. A year later he developed severe thrombocytopenia three days after taking sodium valproate for headache. Astonishingly his bone marrow examination revealed chronic myelomonocytic leukemia. His BCR ABL was negative. Corticosteroids and supportive care with platelet concentrates and whole blood was given but he could not make.