Monoclonal gammopathy of undetermined significance: Difference between revisions

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==[[Monoclonal gammopathy of undetermined significance natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==[[Monoclonal gammopathy of undetermined significance natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
Frequent complications of [[Monoclonal gammopathy of undetermined significance]] include fractures specially in [[lumbar]] vertebrae and [[Thromboembolic disease|thromboembolic]] phenomena. MGUS, is considered as a pre-malignant condition, and its transformation to [[multiple myeloma]]. However, as it mostly occurs in elderly, and its slow rate of progression, only a small proportion of people go on to develop a [[haematological malignancy]]. In patients with MGUS, although the actuarial risk of myeloma at 25 years of follow-up is 30%, the actual risk (when competing causes of death are taken into account) is only 11%.
Frequent complications of [[Monoclonal gammopathy of undetermined significance]] include fractures specially in [[lumbar]] vertebrae and [[Thromboembolic disease|thromboembolic]] phenomena. MGUS, is considered as a pre-malignant condition, and its transformation to [[multiple myeloma]]. However, as it mostly occurs in elderly, and its slow rate of progression, only a small proportion of people go on to develop a [[haematological malignancy|hematological malignancy]]. In patients with MGUS, although the actuarial risk of myeloma at 25 years of follow-up is 30%, the actual risk (when competing causes of death are taken into account) is only 11%.


==Diagnosis==
==Diagnosis==

Revision as of 16:39, 8 August 2018

Monoclonal gammopathy of undetermined significance
ICD-10 D47.2
ICD-9 273.1
DiseasesDB 1341
MeSH D008998

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Omer Kamal, M.D. [2]

Synonyms and keywords: Benign monoclonal gammopathy; MGUS; monoclonal gammopathy, benign

Overview

Historical Perspective

Classification

Monoclonal gammopathy of undetermined significance (MGUS) may be classified according to cytogenetic differences into subtypes/groups based on translocations. There is no established system for the staging of Monoclonal gammopathy of undetermined significance (MGUS).

Pathophysiology

Pathologically, the lesion in Monoclonal gammopathy of undetermined significance is in fact very similar to that in multiple myeloma. What causes Monoclonal gammopathy of undetermined significance to transform into multiple myeloma is as yet unknown.

Causes

The most common causes of Monoclonal gammopathy of undetermined significance classification are genetic mutations in genes like cyclin D1, FGFR-3, MMSET, C-MAF, and MAFB.  

Differentiating Monoclonal gammopathy of undetermined significance from other Diseases

Several other illnesses can present with a monoclonal gammopathy, and the monoclonal protein may be the first discovery before a formal diagnosis is made like multiple myeloma, AIDS, chronic lymphocytic leukemia, non-Hodgkin Lymphoma, particularly splenic marginal zone lymphoma and lymphoplasmocytic lymphoma.

Epidemiology and Demographics

The incidence of Monoclonal gammopathy of undetermined significance is approximately 120 per 100,000 in men at age 50, and goes to 530 per 1000 by the age 90. Women, however, have 60 cases per 1000 at age 50 which goes upto 370 per 1000 at age 90. The prevalence of Monoclonal gammopathy of undetermined significance is different in different populations.

Risk Factors

Common risk factors in the development of monoclonal gammopathy of undetermined significance include African american race, age, male sex, family history, history of immunosuppression and exposure to pesticides.

Screening

There is no role of screening in patients for monoclonal gammopathy of undetermined significance

Natural History, Complications and Prognosis

Frequent complications of Monoclonal gammopathy of undetermined significance include fractures specially in lumbar vertebrae and thromboembolic phenomena. MGUS, is considered as a pre-malignant condition, and its transformation to multiple myeloma. However, as it mostly occurs in elderly, and its slow rate of progression, only a small proportion of people go on to develop a hematological malignancy. In patients with MGUS, although the actuarial risk of myeloma at 25 years of follow-up is 30%, the actual risk (when competing causes of death are taken into account) is only 11%.

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1


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