A 62-Year-Old Man Who Demands Testing: Osmosis USMLE Study Question

April 03, 2020

A monoclonal gammopathy is a disorder characterized by an abundance of a monoclonal immunoglobulin in the serum of an affected patient. Depending on the type of immunoglobulin and the presence, or lack thereof, of associated symptoms, the name of the diagnosis varies. In this case, the asymptomatic patient was incidentally found to have this excess protein on routine bloodwork.

Monoclonal gammopathy of undetermined significance (MGUS), which is caused by a monoclonal expansion of plasma cells, is the most common type of plasma cell dyscrasia. In some patients, the number of monoclonal plasma cells increases sufficiently enough that the disorder progresses to one of several potential malignant diseases, such as multiple myeloma, or Waldenstrom macroglobulinemia. Because these two malignancies can each present with dangerous clinical symptoms, routinely monitoring patients with MGUS for increases in serum levels of immunoglobulins that would signify a malignant transformation of the condition is important.

Major Takeaway: A monoclonal gammopathy is a disorder characterized by an abundance of a monoclonal immunoglobulin in the serum of an affected patient. MGUS, which is caused by a monoclonal expansion of plasma cells, is the most common type of monoclonal gammopathy.

Read more on MGUS.

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