MGUS (Monoclonal gammopathy of unknown significance), aka benign monoclonal gammopathy )BMG) falls under the category of plasma cell disorders in which an abnormal amount of a single immunoglobulin is present in the serum. This monoclonal spike, or M component, is seen in multiple myeloma, Waldenstrom’s macroglobulinemia, primary amyloidosis and various rare heavy chain diseases. MGUS probably represents the common manifestation of multiple disorders and normal variants but it is considered a distinct entity from malignant disorders like non-plasma cell leukemias and lymphomas which occasionally produce an M-spike.
This disorder is fairly common. MGUS increases with age from about 0.1-1% in adults over 25 to 3% in patients over 70, 10% over 80 and more than 20% in patients older than 90. It is more common in blacks than whites and more common in the United States than in Asia. The incidence of multiple myeloma is about .03% per year in patients over 50. This difference in incidence creates the problem of differentiating the rare cases of MM from the more common MGUS.
Whole lists of disorders are associated with a transient monoclonal gammopathy. These include a host of infections, inflammatory diseases, transplants of inorganic material (silicone, valves) and some malignancies. The malignancies are interesting as the M-spike is actually thought to be a plasma cell mediated immune response to the tumor. This spike is common with some tumors known for producing a vigorous immune response, such as melanoma. In most cases of chronic MGUS there is no known cause but a genetic predisposition is clear.
MGUS suggests the following may be present
Anemia, Megaloblastic
Some doctors believe that the fundamental cause of MGUS and Multiple Myeloma, without which all the diverse known risk factors [from benzene to paints and solvents, from hair dyes and asbestos, to pesticides and radiation] may not be potentiated, is a chronic, sometimes subtle deficiency of vitamin B12. Further details about this hypotheses can be reviewed here.
Doing things that could reduce the incidence of multiple myeloma may reduce the risk of MM associated with MGUS. These include increasing pacreatic enzyme intake, and the use of selenium and B12.
Increased Risk of Lymphoma
With time, many people with MGUS eventually develop multiple myeloma, lymphoma, or a disease called amyloidosis. The rate of this happening is about 1% per year. The risk of this happening is higher in people whose protein levels are particularly high. Patients with MGUS usually need frequent medical examinations and tests to detect possible progression to multiple myeloma, but they do not need immediate treatment.
Recommendations for MGUS
Key
| Strong or generally accepted link |
| May do some good |
Glossary
Benign
Literally: innocent; not malignant. Often used to refer to cells that are not cancerous.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
Malignant
Dangerous. mainly used to describe a cancerous growth -- when used this way, it means the growth is cancerous and predisposed to spreading.
Millimeter
(mm): A metric unit of length equaling one thousandth of a meter, or one tenth of a centimeter. There are 25.4 millimeters in one inch.
Melanoma
A life-threatening type of skin cancer that occurs in the cells (melanocytes) that produce melanin, the pigment found in skin, hair, and the iris of the eyes.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Cobalamin
Vitamin B-12. Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Selenium
An essential element involved primarily in enzymes that are antioxidants. Three selenium- containing enzymes are antioxidant peroxidases and a fourth selenium-containing enzyme is involved in thyroid hormone production. The prostate contains a selenium-containing protein and semen contains relatively large amounts of selenium. Clinical studies show that selenium is important in lowering the risk of several types of cancers. In combination with Vitamin E, selenium aids the production of antibodies and helps maintain a healthy heart. It also aids in the function of the pancreas, provides elasticity to tissues and helps cells defend themselves against damage from oxidation.
Lymphoma
Any tumor of the lymphatic tissues.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.