title: Decreased anion gap in polyclonal hypergammaglobulinemia.
abstract: OBJECTIVE
  The anion gap has proved a valuable tool in the diagnosis of various forms of acid-base disorders, although the importance of slight rises in the anion gap remains unclear. The concept of the anion gap is often misunderstood and misapplied. The relationship between gammaglobulins and the serum anion gap has not received much attention except for reports of a narrowing of the gap associated with certain monoclonal immunoglobulin G gammopathies. We present patients with polyclonal gammopathy, the magnitude of which correlated strongly and negatively with the anion gap.
  
  
  METHODS
  The anion gap can be readily calculated from routine laboratory data, and anion gap was calculated as ([Na] +[K])- ([Cl] + [HCO3]).
  
  
  METHODS
  Serum anion gaps were determined in 206 patients with polyclonal hypergammaglobulinemia and 63 healthy subjects.
  
  
  METHODS
  Serum sodium and potassium ions concentration were determined by flame photometry. Serum bicarbonate level was measured as total carbon dioxide content. Serum chloride level was determined by chlorimetric titration with silver ions.
  
  
  RESULTS
  All patients with polyclonal hypergammaglobulinemia had a statistically significant reduction in their mean serum anion gaps (6.4 +/- 1.2 mmol/L) when compared with normal control volunteers (15.3 +/- 2.4 mmol/L), p < 0.05.
  
  
  CONCLUSIONS
  Our results show a negative correlation between serum anion gap and gammaglobulins concentration.
authors.affiliation: Department of Biochemistry and Biophysics, Babol University of Medical Sciences, Faculty of Medicine, Babol, Iran. dqujeq@hotmail.com
authors.forename: Durdi
authors.initials: D
authors.lastname: Qujeq
authors.forename: Javad
authors.initials: J
authors.lastname: Mohiti
mesh_terms: D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D000838:Anions / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D005719:gamma-Globulins / Q000032:analysis
chemical_list: D000838:Anions; D005719:gamma-Globulins