How is monoclonal gammopathy of undetermined significance (MGUS) managed?

Updated: Sep 07, 2018
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

No treatment is recommended for patients with MGUS. [29] Long-term follow-up is generally advised, given the risk of progression to lymphoproliferative malignancy. [35]  

If a patient has no other features of a plasma cell dyscrasia and if a serum M-spike is detected, complete assessment of the patient's general medical status is needed. The assessment should include the following:

  • Baseline measurements of serum vitamin B12 and red blood cell folate levels and a hypercoagulation profile

  • Specific workup relative to the gammopathy, with a bone marrow examination, skeletal radiography (including single views of the humeri and femurs and complete spinal with optional lateral views), and a 24-hour urine collection for protein quantitation

If a patient has an IgM M-protein, aspiration and biopsy of the bone marrow and computed tomography (CT) scanning of the abdomen may be useful in detecting Waldenström macroglobulinemia or other lymphoproliferative disorders.


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