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Gamopatia monoclonal de significado indeterminado

Last reviewed: 22 Sep 2025
Last updated: 10 May 2023

Summary

Definition

History and exam

Key diagnostic factors

  • em situação de risco demográfico (homem, idade > 50 anos, de ascendência africana)
  • clinicamente assintomática
  • história familiar positiva
  • história de exposição à radiação.
  • história de exposição a pesticidas
Full details

Other diagnostic factors

  • história de imunossupressão ou infecções
  • presença de neuropatia periférica
Full details

Risk factors

  • sexo masculino
  • idade >50 anos
  • Ancestralidade africana
  • história familiar de MGUS ou mieloma múltiplo
  • doenças mediadas imunologicamente
  • exposição à radiação
  • exposição a pesticidas
Full details

Diagnostic investigations

1st investigations to order

  • eletroforese com imunofixação e medição de imunoglobulinas séricas
  • Hemograma completo com diferencial
  • cálcio sérico
  • creatinina sérica
  • urinálise e coleta de urina de 24 horas com eletroforese e imunofixação
  • ensaio de cadeias leves livres no soro
  • pesquisa de metástase óssea (raios X convencionais ou TC do corpo inteiro de baixa dose)
Full details

Investigations to consider

  • biópsia e/ou aspiração da medula óssea
  • densitometria óssea
  • ressonância nuclear magnética (RNM)
  • tomografia por emissão de pósitrons (PET)
Full details

Treatment algorithm

ONGOING

gamopatia monoclonal de significado indeterminado (MGUS) confirmada

Contributors

Authors

Shaji Kumar, MD

Professor of Medicine

Division of Hematology

Mayo Clinic

Rochester

MN

Disclosures

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.

Acknowledgements

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

Disclosures

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.

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text  Abstract

van de Donk NW, Palumbo A, 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.Full text  Abstract

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.Full text  Abstract

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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