Presentation
Further, our first case suggests that a monoclonal gammopathy may not be present at the onset of disease but may present later in the course. [omicsonline.org]
Four of the patients presented hypocomplementaemia but the cryoglobulin determinations were negative for all of them. [revistanefrologia.com]
Since significant disease can be present at any level, several different tests are employed in order to encompass the inherent diverse nature of the M-proteins. [ncbi.nlm.nih.gov]
An M protein is typically an incidental finding when a patient is being assessed for any of a number of presenting symptoms or conditions. [mdedge.com]
Workup
Complete hematologic workup with serum and urine protein electrophoresis, immunofixation, and serum-free light-chain assay is required. [theisn.org]
A kappa-lambda ratio below 0.37 or above 3 is rarely seen in chronic kidney disease and should prompt workup for MGUS. 16 Tests in combination. [mdedge.com]
BM examination should be part of the diagnostic workup for all IgA and IgM M-proteins. [haematologica.org]
Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood 2011;117:4701–5. Google Scholar 7. [degruyter.com]
Thus, renal biopsy along with detailed hematologic workup is essential to link the presence of the paraprotein to the associated renal disease. [cjasn.asnjournals.org]
Treatment
Conclusions : Exudative maculopathy unresponsive to conventional treatment may suggest an underlying hematologic condition. [iovs.arvojournals.org]
It is evident that a period of at least three years of close observation without treatment should be the routine. "Prophylactic" treatment of BMG with cytostatic drugs should never be attempted. [ncbi.nlm.nih.gov]
The treatment of MGRS-related kidney diseases should be tailored to the clone responsible. In the past, part of the reticence for withholding treatment was that alkylators were the only antiplasma cell therapies available. [bloodjournal.org]
Those who failed to improve with the initial treatment received an alternative second or third treatment at the discretion of the treating physician. [jnnp.bmj.com]
[…] service, product or treatment in your circumstances. [leukaemia.org.au]
Prognosis
Characterization of primary systemic amyloidosis, clinical manifestations and disease prognosis. [cima.unav.edu]
Prognosis MGUS is generally considered benign and has no ill effects on overall health or survival. However, regular check-ups are essential, since myeloma typically develops in 1% to 2% of MGUS patients per year. [cancer.uams.edu]
In addition, serum FLC measurements have shown utility in determining the prognosis of and in detecting and monitoring light chain amyloidosis. [aacc.org]
N/A What should you tell the patient and the family about prognosis? MGUS is a common finding in clinical practice. [cancertherapyadvisor.com]
A long-term study of prognosis in monoclonal gammopathy of undetermined significance. N Engl J Med 2002;346:564–9. Google Scholar 5. Dispenzieri A, Katzmann JA, Kyle RA, Larson DR, Melton LJ 3rd, Colby CL, et al. [degruyter.com]
Etiology
Monoclonal gammopathy is identified in 10% of patients with idiopathic peripheral neuropathy, and the presence of a monoclonal protein may have significant implications regarding the etiology, progression, and prognosis of the neuropathy. [medlink.com]
Only a few case reports in the past have implicated visceral leishmaniasis as an etiology of monoclonal gammopathy. 2-4 In one case, the patient had a monoclonal triple band. 2 In few cases BMA did not reveal LD bodies, and antileishmanial serology was [scielo.br]
Etiologic Factors for MGUS and Prospects for Primary Prevention Recent observations offer important clues, indicating that genetic predisposition and potentially preventable environmental factors may play a key role in the development of MGUS. [clincancerres.aacrjournals.org]
[…] include IgH translocation, hyperdiploidy and cyclin D dysregulation Secondary genetic events include: NRAS, KRAS and BRAF mutations NFkB pathway mutations TP53, PTEN and RB inactivation Most non-IgM MGUS cases are IgG, followed by IgA, biclonal and IgD Etiology [pathologyoutlines.com]
Repeat CT of his chest revealed a new right lower lobe consolidation abutting the diaphragm with surrounding ground-glass opacity most consistent with pneumonia and two new lung nodules that were likely infectious in etiology. [omicsonline.org]
Epidemiology
“Monoclonal gammopathy of undetermined significance and smoldering myeloma: new insights into pathophysiology and epidemiology”. Hematology Am Soc Hematol Educ Program. vol. 2010. 2010. pp. 295-302. [cancertherapyadvisor.com]
Detailed classification of MGUS: A roadmap for monitoring patients Extensive epidemiologic and clinical studies have refined the classification of MGUS 3-5 and related disorders ( TABLES 2-4 ), 3 providing physicians with guidance on how to monitor patients [mdedge.com]
J Clin Pathol 35:63–68 PubMed CrossRef Google Scholar Salmon SE, Kyle RA (1994) Silicone gels, induction of plasma cell tumors, and genetic susceptibility in mice: a call for epidemiologic investigation of women with silicone breast implants. [link.springer.com]
History of the Rochester Epidemiology Project. Mayo Clin Proc 1996 ;71: 266 - 274 16. Kyle RA, Katzmann JA, Lust JA, Dispenzieri A. Immunochemical characterization of immunoglobulins. In: Rose NR, Hamilton RG, Detrik B, eds. [nejm.org]
"Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma: a review of the current understanding of epidemiology, biology, risk stratification, and management of myeloma precursor disease". [en.wikipedia.org]
Pathophysiology
“Monoclonal gammopathy of undetermined significance and smoldering myeloma: new insights into pathophysiology and epidemiology”. Hematology Am Soc Hematol Educ Program. vol. 2010. 2010. pp. 295-302. [cancertherapyadvisor.com]
More prevalent in African Americans than Caucasians (2 - 3 fold) ( Leukemia 2014;28:1537 ) More common in men than women (1.5:1) Non-IgM MGUS represents up to 85% of MGUS cases Pathophysiology Origin is clonal mature plasma cells residing in the bone [pathologyoutlines.com]
[…] numbness or tingling. [1] Severe renal disease has also been found in a subset of those with monoclonal gammopathy. [1] MGUS is usually detected by chance when the patient has a blood test for another condition or as part of standard screening. [1] Pathophysiology [en.wikipedia.org]
These techniques will no doubt increase our understanding of the pathophysiology and advance the treatment of these patients. [degruyter.com]
From a pathophysiological point of view, it is reasonable to include light-chain disease in MGUS, since it clearly also represents a gammopathy ref. [ufrgs.br]
Prevention
Etiologic Factors for MGUS and Prospects for Primary Prevention Recent observations offer important clues, indicating that genetic predisposition and potentially preventable environmental factors may play a key role in the development of MGUS. [clincancerres.aacrjournals.org]
This progression cannot be prevented. [merckmanuals.com]
In some cases, treatment aimed at preventing progression to active myeloma is indicated. Prognosis MGUS is generally considered benign and has no ill effects on overall health or survival. [cancer.uams.edu]
Blood disorders affect one or more parts of the blood and prevent your blood from doing its job. They can be acute or chronic. Many blood disorders are inherited. [icdlist.com]
Asymptomatic Patients Practice guidelines do not recommend routine screening for MGUS in the general population because of the lack of proven benefit and the absence of curative or preventive therapy. [ashclinicalnews.org]