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Decreased Anion Gap Associated With Hypoalbuminemia and Polyclonal Gammopathy
Amin A. Nanji, MB, ChB;
Donald J. Campbell, PhD;
Morris R. Pudek, PhD
JAMA. 1981;246(8):859-860.
Abstract
Anion gaps were determined in 82 patients with hypoalbuminemia; 24 of these patients had a polyclonal increase in  -globulin levels (designated group 5). The 58 patients without the polyclonal increase in -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 -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.
(JAMA 1981;246:859-860)
Author Affiliations
From the Division of Clinical Chemistry, Vancouver General Hospital, and the University of British Columbia, Vancouver.
Footnotes
Reprint requests to Division of Clinical Chemistry, Vancouver General Hospital, 855 W 12th Ave, Vancouver, British Columbia, V5Z 1M9, Canada (Dr Nanji).
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