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Monoclonal gammopathy of undetermined significance

Última revisão: 1 Sep 2025
Última atualização: 10 May 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • at-risk demographic (male, age >50 years, African ancestry)
  • clinically asymptomatic
  • positive family history
  • history of radiation exposure
  • history of pesticide exposure
Detalhes completos

Outros fatores diagnósticos

  • history of immunosuppression or infections
  • presence of peripheral neuropathy
Detalhes completos

Fatores de risco

  • male sex
  • age >50 years
  • African ancestry
  • family history of MGUS or multiple myeloma
  • immune-mediated conditions
  • radiation exposure
  • pesticide exposure
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • electrophoresis with immunofixation and measurement of serum immunoglobulins
  • CBC with differential
  • serum calcium
  • serum creatinine
  • urinalysis and 24-hour urine collection with electrophoresis and immunofixation
  • serum free light chains assay
  • metastatic bone survey (conventional x-ray or whole body low-dose CT scan)
Detalhes completos

Investigações a serem consideradas

  • bone marrow aspiration and/or biopsy
  • bone mineral density scan
  • MRI scan
  • PET scan
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

confirmed MGUS

Colaboradores

Autores

Shaji Kumar, MD

Professor of Medicine

Division of Hematology

Mayo Clinic

Rochester

MN

Declarações

SK has received research funding for clinical trials to the institution from Abbvie, Amgen, Allogene, Astra-Zeneca, BMS, Carsgen, GSK, Janssen, Novartis, Roche-Genentech, Takeda and Regeneron. SK has participated in consulting and advisory board activities (with no personal payments) for Abbvie, Amgen, BMS, Janssen, Roche-Genentech, Takeda, Astra-Zeneca, Bluebird Bio, Secura Biotherapeutics, Trillium, Loxo Oncology, K36, Sanofi, ArcellX, and (with personal payment) Oncopeptides, Beigene and Antengene.

Agradecimentos

Professor Shaji Kumar would like to gratefully acknowledge Dr Ola Landgren, a previous contributor to this topic.

Declarações

OL is an author of several references cited in this topic.

Revisores

Daniel Catovsky, MD

Consultant Haemato-Oncologist

Section of Haemato-Oncology

Brookes Lawley Institute of Cancer

Sutton

UK

Declarações

DC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014 Nov;15(12):e538-48.Texto completo  Resumo

van de Donk NW, Palumbo A,R Johnsen HE, et al. The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network. Haematologica. 2014 Jun;99(6):984-96.Texto completo  Resumo

Bird J, Behrens J, Westin J, et al. UK Myeloma Forum (UKMF) and Nordic Myeloma Study Group (NMSG): guidelines for the investigation of newly detected M-proteins and the management of monoclonal gammopathy of undetermined significance (MGUS). Br J Haematol. 2009 Oct;147(1):22-42.Texto completo  Resumo

Kyle RA, Durie BG, Rajkumar SV, et al; International Myeloma Working Group. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management. Leukemia. 2010 Jun;24(6):1121-7.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Monoclonal gammopathy of undetermined significance images
  • Diagnósticos diferenciais

    • Multiple myeloma or smoldering myeloma
    • Amyloidosis
    • Waldenström macroglobulinemia
    Mais Diagnósticos diferenciais
  • Diretrizes

    • International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma
    • The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Monoclonal gammopathy of undetermined significance

    Mais Folhetos informativos para os pacientes
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