What Cancers Cause Low Anion Gap

A low anion gap level is rare and indicates an abnormally high level of positively charged molecules. The most common cause of which, is multiple myeloma. Multiple myeloma is a cancer of a class of white blood cells called plasma cells.

Treatments can address the health issue responsible for an abnormal anion gap reading. Measuring the anion gap alone cannot confirm any diagnosis, so a doctor performs a variety of other tests before making a diagnosis and a treatment plan.

A low anion gap reading is very rare, and it often results from a laboratory error. As a result, a doctor who finds a low reading typically orders a second test.

Hypoalbuminemia and a resulting low anion gap can occur in people with multiple myeloma. It is unclear, however, whether measuring the anion gap can help doctors monitor the progression of this type of cancer.

If a person has a pH imbalance, they may have high acid levels, called “acidosis,” or high levels of bases, known as “alkalosis.”

A condition called hypoalbuminemia can cause a low anion gap reading, but this is less common than a laboratory error.

Background: The serum anion gap is an effective tool to analyze acid- base disorders for the past 40 years. Anion gap and non-anion gap acidosis is prevalent in cancer patients and contributes to morbidity and mortality The aim of the present study was to investigate the independent association of serum anion gap with cancer mortality. Methods: We examined the 34,370 participants ( ≥ 20years of age) using National Health and Nutrition Examination survey data (1999-2010) combined with National Death Index for mortality status through December 2011.The serum anion gap was calculated by subtracting sum of chloride and bicarbonate from sodium concentrations in meq/l. We divided the data set in to four quartiles of serum anion gap. Cox proportional hazard models were made to estimate the hazard ratios for cancer mortality for each unit increase in serum anion gap. The models were adjusted from demographic and confoundig variables. Results: The mean age of participants was 49.59±18.42 years. Out of total population 33,717(98.1%) were alive and 651 (1.9%) were dead secondary to cancer. The mean period of follow up was 5.55±3.53 years. In univariate regression model using serum anion gap as continuous variable, we found 6% (HR-1.06;95%CI,1.0-1.1), increase in cancer mortality with each unit increase in serum anion gap. After adjusting for potential confounders using multivariate regression model we found 8%(HR-1.08;95%CI,1.03-1.14), increase in cancer mortality with each unit increase in serum anion gap. In univariate regression model using quartiles, we found 47% (HR-1.47;95%CI,1.04-1.93), increase in cancer mortality with each unit increase in serum anion gap in highest quartile compared to the lowest quartile. After adjusting to the potential confounders the risk for cancer mortality increases to 60% in highest quartile comparison to lowest quartile (HR-1.60;95%CI,1.12-2.26). Conclusions: We found a linear association between serum anion gap and cancer mortality. A high serum anion gap is associated with increase in cancer mortality and may be the prognostic indicator of cancer mortality in general population. This should be validated by performing further investigation.© 2017 by American Society of Clinical Oncology

Monoclonal gammopathies can be associated with conditions such as multiple myeloma. Polyclonal gammopathies are often associated with various inflammatory diseases.

The anion gap is a value that’s calculated using the results of an electrolyte blood test.

If your doctor suspects that you have an electrolyte imbalance in your blood, they’ll order an anion gap blood test.

Electrolytes are elements and compounds that occur naturally in the body and control important physiological functions. Calcium, chloride, magnesium, and sodium, among others, are electrolytes.

A high anion gap value means that your blood is more acidic than normal. It may indicate that you have acidosis. Conditions that can cause acidosis (and therefore a high anion gap value) include:


What diseases cause low anion gap?

A low anion gap test result may mean you have alkalosis (blood that is less acidic than normal).

Acidosis may be caused by:
  • Dehydration.
  • Diarrhea.
  • Too much exercise.
  • Kidney diseases.
  • Diabetes (diabetic ketoacidosis)
  • Certain medicines and poisons.

What decreases an anion gap?

An increased or normal anion gap metabolic acidosis is typically due to excess acid and/or decreased base. A reduction in the anion gap is most commonly due to decreased albumin concentration as albumin is the primary unmeasured anion.

Is low anion gap common?

Having a low anion gap blood test result is rare.

Why multiple myeloma has low anion gap?

In addition to displacement of sodium-containing water from serum by large amounts of non-sodium-containing paraproteins, some paraproteins (eg, IgG in multiple myeloma) can have a net positive charge at physiological pH. This leads to an increase in unmeasured cations and a low anion gap7, 8).

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