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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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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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mgus
written by Boulet , October 05, 2011

i have been diagnossed with mgus 12 months ago,before this i ignored the nerve damage in my hands and feet for approx 1 year,yes they got worst. the nervologist said there is nothing he can do,i work as a hard labourer ,im 51 yrs old about to see a hemotologist for the first time.i had a 5 month waiting list and an updated blood test.how bad does this numbing get,im not in pain yet,
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Re: MGUS/Multiple myeloma
written by James Hubbard, M.D. , October 03, 2011

In multiple myeloma a certain type of blood cell begins multiplying at a faster rate than needed causing damage to the body. This is the usual way cancer does its damage. Smoldering multiple myeloma means it is causing no symptoms right now, and causing minimal damage to the body.

In a 2007 New England Journal study covering 27 years, http://www.nejm.org/doi/full/10.1056/NEJMoa070389 , people with the smoldering type developed the symptomatic, treatment type at a rate of 10 percent per year for the first 5 years after diagnosis, then dropping to about 3 percent per year for the next five years, then 1 percent per year.

There are tests that can be done to predict this a little better.

Treatment is bone marrow transplant or chemotherapy. As with other cancers, ongoing studies are in process to find better and better treatments.

James Hubbard, M.D., M.P.H.
Publisher
MyFamilyDoctorMag.com

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MGUS/Multiple myeloma
written by Jackie , October 03, 2011

I have what my doctor calls smoldering multiple myeloma which started out as MGUS. My doctor says that it's too soon to start treatment, he wants to wait until the condition becomes more active. How long before this become more active and I have to start treatment? What are the treatments?
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Re: Mr
written by James Hubbard, M.D. , October 03, 2011

The "US" in MGUS stands for undetermined significance. MGUS is an early warning sign to watch for other diseases and, if they develop, treat them early to prevent further problems and, yes, death.

There are many reasons for aching legs. It sounds like you're terrified anyway and already assume the worst. Get checked. Who knows? You may feel better.

James Hubbard, M.D., M.P.H.
Publisher
MyFamilyDoctorMag.com

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Mr
written by Philip Gregory Hetzner , September 25, 2011

I have not had my blood checked for my mgus status because I am terrified that is getting serious. My legs ache etc
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Mr
written by Philip Gregory Hetzner , September 25, 2011

Can mgus cause death
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...
written by Philip Gregory Hetzner , September 25, 2011

Are there many fatalities from m-gus
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Re: Male
written by James Hubbard, M.D. , September 25, 2011

Philip: Hopefully you'll be seeing your doctor for a good checkup, including tests for anemia, and vitamin and iron deficiencies.

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

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Re: MGUS
written by James Hubbard, M.D. , September 25, 2011

I'm sorry to hear that. In our article we have some links for further information on MGUS. Mayo Clinic also has some good information on multiple myeloma:
http://www.mayoclinic.com/heal...a/DS00415

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

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Male
written by Philip Gregory Hetzner , September 16, 2011

I have constant aching in my leg bones and get very dizzy when I stand up
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MGUS
written by Jackie , September 15, 2011

Ok, this past February, my doctor told me that I'm one of the few people in which the MGUS turns into multiple myeloma. I just turned 44 and am scared to death. I go to have labs done every 3 months because treatment will have to be started eventually, they don't want to start treatment until my protein level goes a lot higher. I would definitely appreciate any information I can get regarding this condition.
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Mgus
written by Lorna , September 15, 2011

I have been told also that I have mugs, my joints ache all over, and sometimes I cannot bend, I am due to go to see the chronic pain clinic and have blood tests once a year. But I am worried that if I only have these test yearly could it be too late if has increased.

No one seems to come up with an answer. I just want my body back, I was so fit, I do exercising
Every day and enjoy walking the dog. I am 56 lady

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ms
written by dawn crump , September 05, 2011

i have been diagnosed with mgus about 3 years ago which was a blow because i have hep c, diabetes,osteoarthritis,cirrohsis of the liver and all i needed was another ilness to cope with.with regular check ups with a haematologist i have been reasonably well. at 45 years of age and a 4 year old granddaughter i adore i do worry about my future, but i enjoy every day smilies/smiley.gif
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Comment from Sue
written by Sue , June 01, 2011

My partner has had MGUS for many years and he also suffers from Neuropathy. He is always very tired and dizzy. At the moment it is still a watch and wait situation - with blood test every three to six months to see if there is any changes. He is now 68 and on many different medications for his Neuropathy. Although the Doctors have not said there is a link between two, I have also found there is many cases on researching on the Internet.
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Mr
written by Philip Hetzner , May 07, 2011

I have mgus and I have a lot of aching pain in my leg bones as well as constant infections . Please email me if this is happening to you please email me at ___.

[Editor's note: The email address has been removed; please see point number four in our comment policy http://familydoctormag.com/comment-policy.html. Thank you for commenting.]

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Mgus
written by Frances Castruita , May 05, 2011

We just found out that my brother has mgus (never heard of this) he is 50 years old and is a diabetic and has had a heart attack. He is also a worry wort and a highly stressed person. Don't know if any of this is a contributing factor. But if anyone can give more of an explanation of what this blood disorder is I would appreciated emensly. Would like to ease my brothers nerves. Please email.


Thank you,
Concern Sister

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Mgus
written by Cindy , April 02, 2011

I also have MGUS I have had the bone marrow biopsy and so far nothing showed up I go back to the DR in 6 months for blood work it was really upsetting when I found out about it and very scary to.
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MGUS
written by Jackie , February 18, 2011

Hi, I'm relatively new to all of this. I was told that I have MGUS a few years ago. Now, after going to see the doctor earlier this week, I was told that my protein level is 4,800. I've been scheduled to have a bone scan and bone marrow aspiration this coming Monday. Can anyone tell me what all this means?
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MGUS and neuropathy
written by carolyn brislawn , January 30, 2011

My recent blood test showed I have MGUS. My doctor says this has nothing to do with the worsening neuropathy in my feet, but I have found several testimonies on the internet indicating it is very common to have neuropathy with MGUS. As someone above says, I experience dizziness also. I also have a very strange gait when I walk now, making it difficult to walk without looking ''strange''.
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