Abstract
Monoclonal Gammopathy of Undetermined Significance (MGUS) is considered to be a benign precursor condition that may progress to a lymphoproliferative disease or multiple myeloma. Most patients do not progress to an overt condition, but nevertheless, MGUS is associated with a shortened life expectancy and, in a minority of cases, a number of co-morbid conditions that include an increased fracture risk, renal impairment, peripheral neuropathy, secondary immunodeficiency, and cardiovascular disease. This review aims to consolidate current evidence for the significance of these co-morbidities before considering how best to approach these symptoms and signs, which are often encountered in primary care or within a number of specialties in secondary care.
Highlights
Monoclonal Gammopathy of Undetermined Significance (MGUS) is characterized by the presence of a serum monoclonal paraprotein derived from immunoglobulin (Ig)
Non-IgM MGUS is derived from mature plasma cells that may progress to multiple myeloma (MM) [2]
The aim of this review is to examine the most consistently reported co-morbidities associated with MGUS, namely the increased risk of bone fractures, peripheral neuropathy, renal impairment, secondary immunodeficiency, and cardiovascular disease [10]
Summary
Monoclonal Gammopathy of Undetermined Significance (MGUS) is characterized by the presence of a serum monoclonal paraprotein derived from immunoglobulin (Ig). In addition to increasing age, non-IgM MGUS is found more frequently in men and in Afro-Caribbean compared to Caucasian populations [5]. In addition to progression to lymphoproliferative diseases and amyloidosis, patients with MGUS appear to suffer from a greater prevalence of recurrent infections, ischemic heart disease, peripheral neuropathy, and renal diseases compared to those without MGUS [8]. Cancers 2020, 12, 1554 been described, which are reviewed comprehensively elsewhere [9] These co-morbidities afflict only a minority of patients with MGUS, but they need to be considered on an individual patient basis. The aim of this review is to examine the most consistently reported co-morbidities associated with MGUS, namely the increased risk of bone fractures, peripheral neuropathy, renal impairment, secondary immunodeficiency, and cardiovascular disease [10]. Absence of: constitutional symptoms or symptoms and signs of hyper-viscosity, anemia or lymphadenopathy
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