Monoclonal Gammopathies of Undetermined Significance (MGUS) Clinical Presentation

Updated: Sep 23, 2021
  • Author: Suzanne R Fanning, DO; Chief Editor: Emmanuel C Besa, MD  more...
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Presentation

History and Physical Examination

Monoclonal gammopathy of undetermined significance (MGUS) is usually an unexpected finding during an evaluation for an unrelated disorder. The advances in quantification of an M-spike by immunofixation contribute to the increasing number of patients identified as having MGUS.

No specific abnormalities are detected on physical examination in patients with MGUS. Patients with monoclonal gammopathy of clinical significance (MGCS) may present with manifestations related to kidney, neurologic, or skin involvement. [48]

In monoclonal gammopathy of renal significance, variable combinations of proteinuria, hematuria, kidney insufficiency, hypertension, and hypocomplementemia may be seen. [49] Several syndromes of polyneuropathies are associated with plasma cell dyscrasias, including MGUS. Paraproteinemic neuropathy (PPN) is most commonly observed with IgM gammopathy (48%), followed by IgG (37%), and IgA (15%). [31] MGUS with peripheral neuropathy has been designated as monoclonal gammopathy of neurologic significance; this condition occurs more often in IgM MGUS and typically involves slowly progressive, symmetrical, length-dependent sensory deficits. [47]