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Low anion gap
R L Jurado1, C del Rio, G Nassar
1Medical Service, Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, GA 30033, USA.
Southern Medical Journal
|July 22, 1998
Summary
A low anion gap, defined as less than 3 mEq/L, can be a crucial diagnostic clue. Recognizing its significance aids in identifying serious conditions like intoxications or neoplasms.
Area of Science:
- Clinical Chemistry
- Internal Medicine
- Diagnostic Medicine
Background:
- The anion gap is a calculated measure of the difference between measured cations and anions in serum.
- Changes in laboratory methodology have altered the normal reference range for the anion gap.
Purpose of the Study:
- To establish a current definition for a low anion gap.
- To outline the differential diagnosis for a low anion gap.
Main Methods:
- Review of English-language literature on the causes of a low anion gap.
- Analysis of current clinical data to define a low anion gap threshold.
Main Results:
- A low anion gap is defined as < 3 mEq/L.
- A low anion gap can indicate life-threatening intoxications or occult neoplasms.
- A low anion gap may obscure the detection of high anion gap metabolic acidosis.
Conclusions:
- Interpreting a low anion gap provides significant clinical information.
- A low anion gap is an important diagnostic tool that is often underutilized.