Last reviewed: 7 Jan 2023
Last updated: 28 Mar 2019
Summary
Definition
History and exam
Key diagnostic factors
- at-risk demographic (male, age >50 years, African ancestry)
- clinically asymptomatic
- positive family history
- history of radiation exposure
- history of pesticide exposure
More key diagnostic factors
Other diagnostic factors
- history of immunosuppression or infections
- presence of peripheral neuropathy
Other diagnostic factors
Risk factors
- male sex
- age >50 years
- African ancestry
- family history of MGUS or multiple myeloma
- immune-mediated conditions
- radiation exposure
- pesticide exposure
More risk factors
Diagnostic investigations
1st investigations to order
- 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)
More 1st investigations to order
Investigations to consider
- bone marrow aspiration and/or biopsy
- bone mineral density scan
- MRI scan
- PET scan
More investigations to consider
Treatment algorithm
ONGOING
confirmed MGUS
Contributors
Authors
Shaji Kumar, MD
Professor of Medicine
Division of Hematology
Mayo Clinic
Rochester
MN
Disclosures
SK has served as a consultant for Janssen, Abbvie, Amgen, Merck, Celgene, Takeda, and Skyline.
Acknowledgements
Professor Shaji Kumar would like to gratefully acknowledge Dr Ola Landgren, a previous contributor to this topic. OL is an author of several references cited in this topic.
Peer reviewers
Daniel Catovsky, MD
Consultant Haemato-Oncologist
Section of Haemato-Oncology
Brookes Lawley Institute of Cancer
Sutton
UK
Disclosures
DC declares that he has no competing interests.
Differentials
- Multiple myeloma or smoldering myeloma
- Amyloidosis
- Waldenström macroglobulinemia
More DifferentialsGuidelines
- The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network
- The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders
More GuidelinesPatient leaflets
Monoclonal gammopathy of undetermined significance
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