10-27-2014, 09:03 PM   #1
my little penguin
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Low anion gap

DS tends to be a 13 ( range 10-14)
For anion gap
His latest labs it's was low a 9.
So not too low.
Any ideas ?
DS - -Crohn's -Stelara -mtx
10-28-2014, 06:16 AM   #2
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1. What is anion gap?
Anion gap (AG or AGAP) is a value calculated using the results of an electrolyte panel. It is used to help distinguish between anion-gap and non-anion-gap metabolic acidosis. Acidosis refers to an excess of acid in the body; this can disturb many cell functions and should be recognized as quickly as possible, when present. AG is frequently used in the hospital and/or emergency room setting to help diagnose and monitor acutely ill patients. If anion-gap metabolic acidosis is identified, the AG may be used to help monitor the effectiveness of treatment and the underlying condition.

Specifically, the anion gap evaluates the difference between measured and unmeasured electrical particles (ions or electrolytes) in the fluid portion of the blood. According to the principle of electrical neutrality, the number of positive ions (cations) and negative ions (anions) should be equal. However, not all ions are routinely measured. The calculated AG result represents the unmeasured ions and primarily consists of anions, hence the name “anion gap.” The most commonly used formula is:

Anion Gap (AG) = Sodium - (Chloride + Bicarbonate [total CO2])

However, there are other AG formulas, so reference ranges are not interchangeable. Each laboratory formula will have an established normal range that should be referenced.

The anion gap is non-specific. It is increased when the number of unmeasured anions increases, indicating a state of anion-gap metabolic acidosis, but it does not tell the doctor what is causing the imbalance. The metabolic acidosis must be treated to restore the acid/base balance, but the underlying condition must also be identified and treated. Causes can include uncontrolled diabetes, starvation, kidney damage, and ingestion of potentially toxic substances such as antifreeze, excessive amounts of aspirin, or methanol. A low anion gap can also occur; this is most commonly seen when albumin (an anion as well as a protein) is low, while immunoglobulins (cations as well as proteins) are increased.

I'm mom to............... Little Farm Girl 9 yr old
Ibd (microscopic)
dx Juvenile Arthritis
dx Erthema Nodosum
Bladder and Bowel Dysfunction
Ehlers-Danlos Syndrome dx (1/26/17)
Remicade started on (9/8/14)Every 2 wks
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10-28-2014, 07:38 AM   #3
my little penguin
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Thanks I read that one but his albumin is very normal
4.4 out of range 3.8-5.4
So weird
10-28-2014, 08:00 PM   #4
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This probably isn't very helpful, but our range is 6-17 and when DS had a 6 it was in the ER for dehydration and about a week before his resection, so he was pretty miserable at the time.
Mom of DS, age 17, dx Crohn's and Celiac Oct 2008
- Remicade, started Nov 2013
- added Methotrexate/Folate March 2016
- Multivitamins, Probiotics, Vit D
- Small bowel resection, Jan 2013
10-28-2014, 08:50 PM   #5
my little penguin
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Thanks Mehita

I assume its ok since no one called-
I know outside normal labs get flagged right away
So putting my head back in the sand until the next blood draw in 8 weeks
10-28-2014, 08:59 PM   #6
Senior Member
Our range is 0-15. A was at an 8 on her last admission (very dehydrated). She had several things that were off, but that one was considered okay. I totally understand the worry though.
A is 13

Diagnoses: Immune Dysfunction, Hypogammaglobulinemia, Asthma, Allergies

Treatment: Hizentra, Flovent, Zyrtec, Cellcept
10-29-2014, 03:06 PM   #7
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Join Date: May 2010
Location: New South Wales, Australia
Any increased or persistent bowel movements/diarrhoea prior to blood draw?

Dusty. xxx
Mum of 2 kids with Crohn's.

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