I have MGUS. I was told my protein spike was low, and it was discovered as an incidental finding a few years ago. Recent bloodwork revealed again that it was "low". I have no symptoms of anything that can be attributed to the MGUS. So.... How often do I need to have the protein level checked, and what are the current figures regarding specifically the percentage of people with MGUS that progress to Myeloma? Out of IgG,M or A, is one more likely to cause disease than another? Does everyone with MGUS need to have a marrow biopsy, or is that reserved for when levels are high (how high?0 or people become symptomatic? I am m44 caucasian and was diagnosed in 2004. thanx...
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
MGUS (monoclonal gammopathy of unknown significance) is defined as a monoclonal protein that is not multiple myeloma. MGUS is most often encountered by neurologist in looking for causes of neuropathy.
MGUS is found more frequently as one ages, with 3% of people older than 70, 10% older than 80 and 20% greater than 90 having an MGUS.
The rate of MGUS turning into multiple myeloma(MM) is relatively rare, and the chance increases with the amount of years that you have had the MGUS. 4% of MGUS will convert to MM in 5 years, 15% in 10 years and 26% in 15 years.
Fatigue, bone pain or anemia should prompt an immediate evaluation. Otherwise, the recommendation is a SPEP (serum protein electrophoresis) and UPEP (urine protein electrophoresis) repeated at 3 months and 6 months, then if the level remains low it can be checked annually. Factors that would be atypical/concerning for MGUS is M-spike greater than 3g/dl (grams per deciliter), anemia, hypercalcemia, decreased levels of other Immunoglobulins and liver dysfunction. IgG is present in 75% of MGUS, with 25% for IgM and IgA. IgM is most often implicated in neuropathy.
Your MGUS should be followed by a hematologist/oncologist and they would decide when and if you need a bone marrow biopsy. It depends on your clinical picture.
I hope this has been helpful.
I was diagnosed with MGUS and had 2 positive SPEP indicating M-spike and my bone marrow came out negative for the protein. My SPEP showed myoclonial proteins. However my last SPEP did not show any spike or proteins. Now my Oncologist don't think I have MGUS because my labs and urine looks fine. I am afraid that if I stop the lab checks, it may be too late if these positive labs return and are now full blown MM. I have a lot of generalized pain, fatigue and sharp tingling pain in my feet and hands. I do have RA. My question is can you have positive SPEP, +M-spikes and all the positive signs of MGUS and now (-)SPEP. What can caused M-spike protien? I am so confused.
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