Negative Anion Gap in a Teenager with Epilepsy

Data on the clinical, analytical, and laboratory factors associated with negative anion gaps at an academic medical center

“…Elevations in anion gap are classically described in a variety of different clinical disease states, including but not limited to drug toxicities (e.g., ethylene glycol, methanol, salicylates), ketoacidosis, and lactic acidosis [2] , [3] , [4] , 8] . Comparatively less is understood about the etiology of anion gaps below the reference range, including 'negative anion gaps’ with values of -1 or lower [9] , [10] , [11] , [12] . Certain pathologic states, drugs, and laboratory abnormalities have been associated with low anion gap measurements [1 , 6 , 8 , 13] .…”