Anion Gap (Low): Difference between revisions

Revision as of 00:50, 27 April 2011

Lab error
Decreased "unmeasured" anions
- hypoalbuminemia
Increased "unmeasured" cations
- hyperkalemia
- hypercalcemia
- hypermagnesemia
- lithium intoxication
Increased cationic paraprotein
- multiple myeloma
- polyclonal IgG gammopathy
Pseudo
- Severe hypernatremia (>170 meq/L)
  - True conc of Na is underestimated
- Marked hyperlipidemia
  - Leads to overestimation of plasma Cl conc)
- Bromide intoxication (e.g. for myasthenia gravis and some herbal medications)

Kaji Questions

Authors:

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 ==Background==
+*< 7 meq/L
-< 7 meq/L
 ==DDX==
+*Lab error
+*Decreased "unmeasured" anions
+**hypoalbuminemia
+*Increased "unmeasured" cations
+**hyperkalemia
+**hypercalcemia
+**hypermagnesemia
+**lithium intoxication
+*Increased cationic paraprotein
+**multiple myeloma
+**polyclonal IgG gammopathy
+*Pseudo
+**Severe hypernatremia (>170 meq/L)
+***True conc of Na is underestimated
+**Marked hyperlipidemia
+***Leads to overestimation of plasma Cl conc)
+**Bromide intoxication (e.g. for myasthenia gravis and some herbal medications)
-) Lab error
+*AG falls by 2.5 meq/L for every 1 g/dL reduction in albumin concentration
-) Decreased "unmeasured" anions
-     a) hypoalbuminemia*
-) Increased "unmeasured" cations
-     a) hyperkalemia
-     b) hypercalcemia
-     c) hypermagnesemia
-     d) lithium intoxication
-) increased cationic paraprotein
-     a) multiple myeloma (do a serum protein electrophoresis to w/o)
-     b) polyclonal IgG gammopathy.
-)  Pseudo
-     a) severe hypernatremia (>170 meq/L)
-          -true concentration of sodium is underestimated
-     b) marked hyperlipidemia (marked overestimation of the plasma chloride concentration)
-     c) bromide intoxication (e.g. for myasthenia gravis and some herbal medications)
-*AG falls by about 2.5 meq/L for every 1 g/dL (10 g/L) reduction in the plasma albumin concentration
-== ==
 ==Source==
 Kaji Questions
 [[Category:Tox]]