Decreased anion gap associated with hypoalbuminemia and polyclonal gammopathy
A. A. Nanji, D. J. Campbell and M. R. Pudek
Anion gaps were determined in 82 patients with hypoalbuminemia; 24 of these
patients had a polyclonal increase in gamma-globulin levels (designated
group 5). The 58 patients without the polyclonal increase in gamma-globulin
levels were subdivided according to the origin of their serum albumin loss
as follows: group 1, renal group 2, gastrointestinal; group 3, skin; and
group 4, malignant neoplasms. All groups had a statistically significant
reduction in their mean anion gaps when compared with normal control
subjects. The greatest decrease was when hypoalbuminemia was accompanied by
a polyclonal increase in gamma-globulin levels. Hypoalbuminemia with or
without a polyclonal gammopathy is a cause of a low anion gap. No
statistically significant correlation was found between the anion gaps and
individual serum albumin concentrations.
