What are the approach considerations in the treatment of monoclonal gammopathy of undetermined significance (MGUS)?

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

MGUS-associated neuropathies are generally not treated, except in the case of a disabling IgM monoclonal gammopathy or IgG/A MGUS associated with chronic inflammatory demyelinating neuropathy (CIDP). About 80% of patients with IgG/A MGUS CIDP respond to one of the typical CIDP treatments and some patients stabilize without therapy. [28]

The intensity of follow-up in patients with MGUS is guided by risk stratification. Typically, initial follow-up at 6 months is recommended, with subsequent visits scheduled according to level of risk (see Long-Term Monitoring). [3, 29, 2] If clinical trials of preventive strategies are available, patients at high risk for progression should be encouraged to participate.

Serum and urine electrophoresis with immunofixation should be performed if the serum M-protein value increases or if other evidence of evolving multiple myeloma or Waldenström macroglobulinemia is observed.


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