MGUS (monoclonal gammopathy of unknown significance) is a non-cancerous condition which can be diagnosed by the presence of an abnormal protein, called a paraprotein or M-protein in the urine or blood.1 There is a small risk associated with MGUS to transform into multiple myelomas or lymphomas.
Is MGUS Or Monoclonal Gammopathy Of Undetermined Significance A Serious Condition?
Monoclonal gammopathy of unknown significance is not a serious condition, but there is risk associated with it to transform into malignancies.2
The condition is often accidentally diagnosed while investigating for some other disease condition. There are other disease conditions which can cause paraproteins in the blood. Doctors perform a differential diagnosis for MGUS. The doctors will advise for complete blood analysis, X-rays and scans and also bone marrow test. The people who are at risk of developing MGUS are advised to undergo testing for every 6 months and other people every year. Older people and people with terminal illnesses need not require continuous monitoring for measuring M-proteins.
Monoclonal gammopathy of unknown significance often does not produce any sign and symptoms of the disease. People with underlying lymphoproliferative malignancies can often experience numbness, tingling, bone lesions, decreased bone density, cardiomyopathy, enlargement of the liver, etc.
Causes of MGUS Or Monoclonal Gammopathy Of Undetermined Significance
The exact cause of MGUS is not known. M-protein is usually not harmful. But the accumulation of M. protein can result in the replacement of healthy bone marrow cells with pre-cancerous plasma cells. Few people are at increased risk of developing monoclonal gammopathy of unknown significance as listed below-
- Immune-Compromised Patients. People suffering from rheumatoid arthritis, infections or similar conditions are at increased risk of developing monoclonal gammopathy of unknown significance.
- Age. It is more common in people who are older than 70 years of age.
- Race. Africans and African-Americans are at increased risk when compared to white Americans
- Gender. The prevalence is higher in males than in females
Genetic and environmental factors may also contribute to the disease.
Although monoclonal gammopathy of unknown significance is described as a premalignant condition only 1% of the population actually predisposes to multiple myeloma or lymphoma.
Monoclonal gammopathy of unknown significance is classified into different types such as Non-IgM MGUS (IgG, IgA or IgD MGUS), IgM MGUS and Light chain MGUS (LC-MGUS). Non-IgM MGUS is the most common form of MGUS and can result in multiple myeloma. IgM MGUS can progress to Waldenstrom macroglobulinemia and in few people lymphoma, AL amyloidosis or multiple myeloma. Light chain MGUS (LC-MGUS) is characterized by the presence of a type of M protein is in your urine, Bence Jones proteinuria.
The progression of the disease is monitored by analyzing the size and type of M proteins in your blood, free light chain protein in the blood, the age of diagnosis, etc.
Detection of paraprotein necessarily does not indicate monoclonal gammopathy of unknown significance but may also be an indication of myeloma or lymphoma. If any doubts doctors may request for differential diagnosis to identify the exact cause for the presence of M-proteins.
Monoclonal gammopathy of unknown significance as such they do not require any treatment. Patients who are diagnosed with MGUS are monitored on regular basis yearly. Patients who have been diagnosed with MGUS with detection of paraproteins are monitored every 6 months for the progression of the disease. There is no cure for the disease doctors have to patiently watch for the progression of the disease.
There are no prevention and treatment measures for monoclonal gammopathy of unknown significance. People diagnosed with lymphoproliferative malignancies are required to be treated for symptoms. Medicines are provided to compensate for the loss of bone mineral density, prevent fractures and other related symptoms. Early diagnosis can help in taking measures to improve the quality of life and survival rate in patients with LPM.
Monoclonal gammopathy of unknown significance is considered as a precancerous condition which can progress to life-threatening cancers in about 1% of the population. As such MGUS does not produce any symptoms of the disease unless the disease has progressed to LPMs. The condition remains asymptomatic for years.
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