Abstract
BackgroundThe prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder has not been determined in our geographic area Nigeria.MethodsA cross sectional survey was carried on apparently healthy Nigerians selected by multistage sampling technique from the cosmopolitan city of Lagos, Nigeria. Subjects enrolled into the study had 2-step screening for the presence, type and concentration of monoclonal band. Agarose-gel electrophoresis was performed on all serum samples, and any serum sample with a discrete band of monoclonal protein or thought to have a localized band was subjected to Immunofixation. Subjects were also evaluated for Bence jones proteinuria, haematological and biochemical parameters.ResultsFour hundred and ten subjects with a mean age of 45.68 ± 10.3 years, a median of 45.00 years and a range of 20 to 80 years were enrolled into the study. MGUS was identified in only one (0.24 percent) of the 410 study subject. This subject was demonstrated to have a double monoclonal gammopathy; IgGλ at 16.9 g/L and IgAκ at 8.5 g/L. None of them including the sole subject with MGUS had a monoclonal urinary light chain.ConclusionAmong residents of Lagos, Nigeria, MGUS was found in only 0.24% percent of apparently normal persons with a median age of 45 years. This suggests that MGUS which represents the earliest stage of monoclonal plasma/lymphoid cell proliferation is not a common finding in the relatively young population of Nigeria. Future epidemiologic studies dealing with plasma cell disorders in older people are required to carefully examine the relationship between environmental factors and prevalence of MGUS and its ultimate progression to MM.
Highlights
The prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder has not been determined in our geographic area Nigeria
One of the 410 subjects who had sera subjected to Agarose gel Serum protein electrophoresis (SPEP) had the β band appearing dense and a discrete band in the γ region. (Figure 1), only 0.24 percent of the sample population has a monoclonal gammopathy
Among residents of Lagos, Nigeria, MGUS was found in 0.24% percent of apparently normal persons with a median age of 45 years
Summary
The prevalence of monoclonal gammopathy of undetermined significance (MGUS), a premalignant plasma-cell disorder has not been determined in our geographic area Nigeria. The term Monoclonal gammopathy of undetermined significance (MGUS) denotes the presence of a monoclonal protein (M-Protein) in plasma or urine without evidence of multiple myeloma (MM), Waldenström’s macroglobulinaemia (WM), amyloidosis, or B cell related disorders [3] It has two important characteristics; the first is a plasma immunoglobulin or serum M protein concentration of less than 3 g/dl, only small or no urinary immunoglobulin light chain (Bence jones proteinuria) that has molecular features of the product of a single clone of B lymphocytes or plasma cells and the second is the absence of evidence of an overt neoplastic disorder of B lymphocyte or plasma cells such as lymphoma or multiple myeloma i.e. less than 10% of plasma cells in bone marrow, no anemia, no osteolytic lesions, no hypercalcemia, and no renal dysfunction and most importantly, stability of the M-protein [4]. Because the benign nature of an MGUS is sometimes difficult to ascertain, repeated examinations of the person over long periods are required
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