What is included in the workup of monoclonal gammopathy of undetermined significance (MGUS)?

Updated: Dec 29, 2019
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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The workup for monoclonal gammopathies of uncertain significance (MGUS) includes the following:

  • Complete metabolic panel - For example, to evaluate renal function, calcium, uric acid, and lactate dehydrogenase (LDH) [35]
  • Complete blood cell count (CBC) with differential - To evaluate for anemia, thrombocytopenia, and neutropenia
  • Tests for beta2 microglobulin and C-reactive protein - For prognostic information
  • Serum and urine electrophoresis with immunofixation - Diagnostic test of choice
  • Quantitative immunoglobulin measurements - To follow up the progress of the monoclonal gammopathy
  • Measurement of the proliferative rate of the plasma cells or plasma cell labeling index (value is low)
  • Serum electrophoresis
  • Serum free light chain (FLC) assay - Beneficial for prognostic purposes
  • Complete skeletal survey to assess for lytic lesions
  • Unilateral bone marrow aspiration and biopsy - To quantify the percentage of plasma cells and to assess for abnormal cytogenetics [36]

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