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lüll Low anion gap Jurado RL; del Rio C; Nassar G; Navarette J; Pimentel JL JrSouth Med J 1998[Jul]; 91 (7): 624-9BACKGROUND: The purpose of this review is to provide a differential diagnosis for a low anion gap. METHODS: We describe the anatomy of the anion gap. Also, we follow-up with a review of the English-language literature describing the causes of a low anion gap. During the past 15 years, the introduction and widespread clinical use of ion-selective electrode methodology for measuring serum electrolyte values has caused a major fall in the normal range of the anion gap from 12 mEq/L +/- 4 mEq/L to 6 mEq/L +/- 3 mEq/L; therefore, a new definition for a low anion gap is in order. RESULTS: Based on current clinical data, an anion gap value of < 3 mEq/L should be considered low. A low anion gap is a useful diagnostic tool, but its clinical significance is often unrecognized. Also, it may be a handy clinical clue for the diagnosis of life-threatening intoxications or occult neoplasms, such as multiple myeloma. The baseline low anion gap may mask the identification of a high gap metabolic acidosis in certain patients. CONCLUSIONS: Interpretation of a low anion gap can provide valuable clinical information.|*Acid-Base Equilibrium[MESH]|Acid-Base Imbalance/*blood/*diagnosis/etiology[MESH]|Bias[MESH]|Diagnosis, Differential[MESH]|Electrolytes/blood[MESH]|Humans[MESH]|Ion-Selective Electrodes[MESH]|Reference Values[MESH]|Reproducibility of Results[MESH] |