PMID: 15365595Sep 15, 2004Paper

Evaluation of serum anion gap in patients with liver cirrhosis of diverse etiologies

The Mount Sinai Journal of Medicine, New York
Hatim HassanBahar Bastani

Abstract

The low serum anion gap (AG) in patients with hepatic cirrhosis is generally attributed to hypoalbuminemia. Serum immunoglobulin G (IgG) (elevated in chronic viral hepatitis) and IgA (elevated in alcoholic cirrhosis) have different isoelectric points, and thus may affect serum AG in opposite directions. To define the normal serum AG in patients with liver cirrhosis of diverse etiologies. We retrospectively compared serum AG of 144 stable cirrhotics and 286 control patients (consecutive hospital admissions with serum creatinine concentration < 2 mg/dL). Serum AG was significantly lower among the cirrhotics, compared to the controls (5.8 +/- 2.2 mEq/L vs. 7.0 +/- 2.2 mEq/L, respectively, p<0.005). However, when patients with serum albumin concentration < 3.5 g/dL were excluded, there was no significant difference between the cirrhotics vs. controls (6.7 +/- 1.8 mEq/L vs. 7.0 +/- 2.2 mEq/L, p=ns). Moreover, patients with liver cirrhosis secondary to chronic viral hepatitis had AG similar to that of the alcoholic cirrhotics (5.6 +/- 2.5 mEq/L vs. 6.0 +/- 1.9 mEq/L, p=ns). There was a positive correlation between serum albumin concentrations > 1.9 g/dL and serum AG, and a tendency toward an inverse correlation between serum globulin...Continue Reading

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