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What is MGUS (monoclonal gammopathy of undetermined significance)?

by James Hubbard, M.D., M.P.H.

doctor-bloodQ. I need more explanation on my diagnosis. I had a serum immunofixation test and it came back with IgG-Lambda monoclonal gammopathy. I then did a 24-hour urine test. Now they say it's monoclonal gammopathy of undetermined significance. I was told to come back every six months for more blood work.

Could you please tell me more about this? Maybe even a good Web page or book I could read. Everything I have found says it's only an old person's disease; I am a healthy, active, 34-year-old mother.

Rebecca, Michigan


A.
Some of the hints about what you have are in the name:

  • monoclonal (one type)
  • gammopathy (abnormal protein)
  • of undetermined significance
newsletter-graphic-free2It's MGUS for short.  Scientists have found an increase in levels of the immunoglobulin M protein in the blood of a few percent of the population, but they're not sure of the significance or the cause.  Sometimes, it will progress to the bone-marrow cancer multiple myeloma. This can happen as many as one in five cases.  However, most people live healthy lives with no symptoms.

Get expert-written articles like this every month in our free health newsletter.


Prognosis for MGUS

Other than living a healthy lifestyle, you will probably need to have a periodic blood test to make sure the M protein in your blood isn't increasing. If it does, you might require treatment—the earlier the better. The good news is, early treatment slows progression, and four in five people with MGUS appear to have no ill effects, leading healthy lives. The bad news is there are a lot of questions yet to be answered about its cause and its significance to your health.


More Information About MGUS
The best information I could find on MGUS was at the Mayo Clinic website. Mayo is at the forefront of research on MGUS.

You mentioned that you've read people with MGUS are generally older. The risk of MGUS does go up with age. Most people who have it are over 50. I did find one article in the New England Journal of Medicine noting that 24 of the 1,384 patients in this particular study were under 40 years old.

It appears we need to learn a lot before we can take off the “undermined significance” part of the name.


JAMES HUBBARD, M.D., M.P.H.,
is the publisher of MyFamilyDoctorMag.com. He's been a family doctor for over 25 years.


You May Also Be Interested In:


Last updated and/or approved: October 2011.
This general health-care information is not meant as individual advice. Please see our disclaimer.
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written by Muriel Friedman , June 23, 2013

I would like to receive your e-mails regarding MGUS and SSM. Thank you.
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Monoclonal gammopathy IgG T120
written by Janet , December 14, 2012

They found my illness by accident, 12 years ago. Treated with Rituxin and Fludara. 36 infusions over 6 months. Been checked quite frequently since then. Still good. Fingers crossed and G-d willing, I'll stay that way. Good luck.
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Re: ...
written by Dr. Hubbard , April 24, 2012

Jackie, I don't know the reason for your pain, but you should see your doctor. Even if it's not related to your smoldering multiple myeloma, it needs to be checked out. Call or see your doctor today.

James Hubbard, M.D.
Publisher, MyFamilyDoctorMag.com and TheSurvivalDoctor.com

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symptoms
written by melanie barton , April 23, 2012

rather than worrying about it Jackie, call your doctor and ask if this is a change in staging.
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...
written by Jackie , April 19, 2012

I was diagnosed with smoldering multiple myeloma in February 2011. I've been going roughly every three months for tests to make sure that everything is ok. Now, two days ago, I've developed really bad back pain and yesterday, I've started having pain in my breastbone. As far as my back pain, I haven't done anything out of the ordinary that would cause this pain and the pain in my back is bad enough to bring me close to tears. Should I be worried about this being caused by the myeloma? The last time I saw my doctor was in early February and he said that everything was ok. Could a change in my staging occur this fast; from smoldering to stage 1 in the span of a few months (February to April)?
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MGUS
written by Norbert Boulet , February 18, 2012

im 52 yrs old.i have mgus,approx 2 yrs ago i was diagnossed with it,jan 2012 my m protein count was very low,im told its possible that i have had mgus for several years and never knew it.i have nerve damage at hands and feet that there still testing why.excuse my english and spelling.i have stopped worrying about mgus and i am happy. no one knows much about it,i dont think it is much,i am told to get my m protiem blood test once a year and go from there.worrying about it like i did for 1.5 years was a wast of time and the anxiety stuff i no longer have.my m protein count is at 3 ,only when it gets to 20 +" there is treatment" to prevent possible blood cloting.
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MGUS: Follow-Up Article Is Published
written by Leigh Ann , October 30, 2011

Good news! The promised follow-up article on MGUS has been published. It answers your questions about symptoms and associated diseases. You can read it here:

http://familydoctormag.com/chronic-disease/1558-mgus-symptoms-diseases.html

Coming next Monday, November 7, we'll publish an article with answers to your questions about multiple myeloma.

Leigh Ann Otte
Managing Editor
www.MyFamilyDoctorMag.com

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Re: MGUS Follow-Up Article Coming
written by Leigh Ann , October 22, 2011

Hi again, everybody. Just a quick update: We're planning to published the MGUS follow-up article Monday, October 31. We're also hoping to publish one about multiple myeloma on the following Monday.

Leigh Ann Otte
Managing Editor
www.MyFamilyDoctorMag.com

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MGUS or MM ? Or does MGUS always turn into MM?
written by JOAN , October 08, 2011

I've had microscopic blood in my urine for 10 years. Urologist said, "NOT NORMAL, but not abnormal" and so had it checked every year with no change. Then I had a blood test with my annual physical, and it showed a slight non iron related anemia. Was casually told that I might THINK about following up with a Hematologist. Did that, and the day I saw him, I had just found out that I had stage zero breast cancer, so he said, "You MIGHT want to do a work-up on this at some point."
Now two years later I went to see my GP saying I was feeling achy & tired thinking maybe because I was turning 70... and he took a dozen vials of blood, and just sent me a letter saying, " The protein electrophoresis demonstrated an "IgG lambda monoclonal protein present". The antinuclear antibody screen was positive on the low titer. In light of the monoclonal protein, which is present, it would be WORTHWHILE for you to see a hematologist/oncologist"
TheY all sounded so nonchalant...and now I'm terrified and will make an appointment asap.

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Follow-Up Article Coming
written by Leigh Ann , October 07, 2011

Hi, everybody.

We can see that there's strong interest in this topic and you guys have a lot of questions you're anxious to get answered. So we've decided to do a follow-up article on MGUS. We're working on contacting experts and will post a notice here when the article's up. We'll also include a link in next month's newsletter: http://familydoctormag.com/newsletters.html .

Thank you for posting your comments and questions. We appreciate knowing what you're interested in.

Leigh Ann Otte
Managing Editor
MyFamilyDoctorMag.com

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