Two cases of severe hypoalbuminemia (<10 g/L).

Hypoalbuminemia is known to occur in critically ill patients and is associated with increased mortality. Severe hypoalbuminemia is defined in the literature as serum albumin levels lower than 24 g/L. Albumin levels were measured in our laboratory using the bromocresol purple method on the Synchron CX9 (Beckman Coulter); the lower detection limit on this apparatus is 10 g/L. We report two cases of severe hypoalbuminemia with levels lower than 10 g/L-one in a complete paraplegic patient with severe pressure ulcers and the other in a patient positive for the human immunodeficiency virus with chronic renal failure. Although cases of severe hypoalbuminemia (<10 g/L) are very rare in the literature, chemical pathologists should be aware of the causes of serum albumin levels of this magnitude. These cases describe two different disease states that lead to severe hypoalbuminemia by means of a similar underlying cause, namely severe inflammation or infection.