Clinical Chemistry
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Clinical Chemistry 22: 1920-1921, 1976;
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Clinical Chemistry, Vol 22, 1920-1921, Copyright © 1976 by American Association for Clinical Chemistry

Negative anion gap in a young adult with multiple myeloma

T Gumprecht, DT O'Connor, A Rearden and PL Wolf

A young patient with multiple myeloma was found to have a negative anion gap, with marked asymptomatic hyponatremia. The cause for his negative anion gap is thought to be the myeloma protein, which acts as a cation at physiological pH. Such a hyponatremia responds to reduction in serum concentration of paraprotein and should not be treated by sodium replacement.


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J. A. Kraut and N. E. Madias
Serum Anion Gap: Its Uses and Limitations in Clinical Medicine
Clin. J. Am. Soc. Nephrol., January 1, 2007; 2(1): 162 - 174.
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Copyright © 1976 by the American Association for Clinical Chemistry.