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J R Soc Med. 1988 January; 81(1): 27–28.
PMCID: PMC1291424

The anion gap as a screening procedure for occult myeloma in the elderly.


Myeloma in the elderly can mimic many disorders, causing delay in diagnosis. In a retrospective study, the mean anion gap at presentation in 78 elderly patients with confirmed myeloma was found to be significantly less than that of aged-matched controls. It is suggested that estimation of the anion gap may be useful as a screening test, particularly as it has no intrinsic cost.

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Selected References

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  • Flanagan NG, Kozlowski CL, Ridway JC. Multiple myeloma in a retirement area. Age Ageing. 1983 May;12(2):131–135. [PubMed]
  • Flanagan NG, Harry DS, Kozlowski T, Sorahan T. Multiple myeloma on the Fylde coast. Br Med J (Clin Res Ed) 1984 Oct 20;289(6451):1075–1075. [PMC free article] [PubMed]
  • Frick PG, Schmid JR, Kistler HJ, Hitzig WH. Hyponatremia associated with hyperproteinemia in multiple myeloma. Helv Med Acta. 1967 Jan;33(4):317–329. [PubMed]
  • Murray T, Long W, Narins RG. Multiple myeloma and the anion gap. N Engl J Med. 1975 Mar 13;292(11):574–575. [PubMed]
  • Schnur MJ, Appel GB, Karp G, Osserman EP. The anion gap in asymptomatic plasma cell dyscrasias. Ann Intern Med. 1977 Mar;86(3):304–305. [PubMed]
  • De Troyer A, Stolarczyk A, De Beyl DZ, Stryckmans P. Value of anion-gap determination in multiple myeloma. N Engl J Med. 1977 Apr 14;296(15):858–860. [PubMed]
  • Paladini G, Sala PG. Anion gap in multiple myeloma. Acta Haematol. 1979;62(3):148–152. [PubMed]

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