I need help deciphering my laboratory reports. Do I have a low anion gap?

Question

Hi doctor,

I am a 31-year-old female. I am currently taking 900 mg daily of Oxcarbazepine; I need help deciphering laboratory results. A few results were either low or high creatinine- 0.526, CL-108, and anion gap-2. Lymphocytes were also 45.5, even though my WBC was 7.7.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the query. I can understand your concern. According to your statement, you have recently have done some blood tests, and the results have shown serum creatinine is slightly below the normal level, and Cl is somewhat above normal. Your total white blood cells (WBC) is 7.7 × 10(3)/uL (range: 3.7 to 10.3), which is within the normal limit. Your lymphocyte counts are 45.5% (range: 20 to 40%), which is above normal. Your albumin level is 4.2 (range 3.5 to 5) g/dL, which is also within the normal range. A low anion gap is very rare. As your electrolyte results have shown low anion, so your doctor may advise you to repeat the test because a low anion gap may result from a laboratory error. Other than a laboratory error, it may indicate hypoalbuminemia, DM (diabetes mellitus), kidney disease, multiple myeloma, certain types of cancer, etc. But your albumin level is within the normal limit. If you are a lean and thin person, your body mass will be less, and your creatinine level may become low. Keep in mind that one blood test does not confirm anything. If your two blood tests from two different laboratories become abnormal, then the blood tests are significant. Otherwise, there is nothing to be worried about. You can do repeat your blood tests to remove any doubts. Take care. I hope I have answered your questions. Let me know if I can assist you further. Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Thanks for joining again. Yes, you are right. Your anion test is likely false positive as your albumin level is within normal limits. And low albumin levels are known as hypoalbuminemia, may indicate kidney disease, heart disease, DM, multiple myeloma, etc. And a low anion gap can mean hypoalbuminemia. As your albumin level is normal, how can I think about hypoalbuminemia and its associated underlying pathology like kidney disease, heart diseases, DM, multiple myeloma, etc.? Again, your lymphocyte count are slightly above normal, which may indicate your body is fighting against some sorts of infections like urinary tract infection, respiratory tract infections, or any other type of infection, dehydration, or any inflammatory conditions, etc. But the good news is that most often, temporary high lymphocytes count is a normal effect of your body's immune system working. So, from my side, there is nothing to be worried about. At best, you can do repeat the blood tests one month later. If any other query, knock me, and I will try to reply to you further. Thank you.