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Related Experiment Videos

Anion gap and immunoglobulin concentration

A A Keshgegian

    American Journal of Clinical Pathology
    |September 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Elevated immunoglobulin levels, both monoclonal and polyclonal, are linked to a decreased serum anion gap. This finding is crucial for accurately assessing acid-base balance in affected patients.

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    Area of Science:

    • Clinical Chemistry
    • Internal Medicine
    • Nephrology

    Background:

    • The serum anion gap (SAG) is a key indicator of acid-base balance.
    • Decreased SAG is typically associated with multiple myeloma or monoclonal gammopathy.
    • The role of diffuse polyclonal immunoglobulin elevations on SAG is less understood.

    Purpose of the Study:

    • To investigate the association between elevated immunoglobulin concentrations and serum anion gap.
    • To determine if polyclonal immunoglobulin elevations also lead to a decreased SAG.
    • To assess the clinical implications of a low SAG in patients with hypergammaglobulinemia.

    Main Methods:

    • Retrospective analysis of 83 patients with moderate-to-severe diffuse immunoglobulin elevations (> 3 g/dl).
    • Comparison of mean serum anion gap between patients with hypergammaglobulinemia and a control group with normal immunoglobulin levels.

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  • Exclusion of known causes for decreased anion gap, such as hyperkalemia and hypercalcemia.

    • Main Results:

    • Patients with elevated immunoglobulin levels (> 3 g/dl) exhibited a significantly lower mean SAG compared to controls (8.7 mEq/l vs. 11.9 mEq/l, P < 0.001).
    • This reduction in SAG was observed irrespective of the immunoglobulin subclass or specific diagnosis.
    • Albumin concentration had a negligible impact on the observed decrease in SAG.

    Conclusions:

    • Diffuse polyclonal immunoglobulin elevations, similar to monoclonal gammopathies, are associated with a significantly decreased serum anion gap.
    • A low serum anion gap should be considered in the acid-base assessment of patients with hypergammaglobulinemia.
    • This finding may necessitate adjustments in the interpretation of metabolic acidosis or alkalosis in these patient populations.