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Clinical Trial
. 2020 Jun;189(6):1127-1135.
doi: 10.1111/bjh.16487. Epub 2020 Jan 30.

The prevalence and significance of monoclonal gammopathy of undetermined significance in acute medical admissions

Catherine Atkin  1 , Vinay Reddy-Kolanu  2 , Mark T Drayson  3 , Elizabeth Sapey  1 , Alex G Richter  3
Affiliations
Clinical Trial

The prevalence and significance of monoclonal gammopathy of undetermined significance in acute medical admissions

Catherine Atkin et al. Br J Haematol. 2020 Jun.

Abstract

Monoclonal gammopathy of undetermined significance (MGUS) affects 3·2% of adults aged >50 years. MGUS carries a life-long risk of progression to multiple myeloma and causes complications including infection and renal impairment; common causes of hospital admission. This study aimed to assess MGUS prevalence in emergency medical hospital admissions. Patients were recruited from unselected emergency medical admissions in a hospital in the United Kingdom. Serum protein electrophoresis was performed, with immunofixation of abnormal results. Reason for admission and routine test results were recorded. After education about MGUS and myeloma, patients chose whether they wished to be informed of new diagnoses. A total of 660 patients were tested and 35 had a paraprotein suggestive of MGUS. The overall rate of MGUS was 5·3%. MGUS prevalence in those aged >50 years was 6·94%, higher than the previously published rate of 3·2% (P < 0·0005). There were higher rates in those with chronic kidney disease (13·75% vs. 4·14%, P = 0·002), heart failure (14% vs. 4·59%, P = 0·012), anaemia (8·96% vs. 3·41%, P = 0·003) or leucocytosis (9·33% vs. 3·04%, P = 0·002). In all, 96% of patients wished to be informed of their screening results. The prevalence of MGUS in emergency hospital admissions is higher than expected based on previous population-based rates. This may suggest a selected population for screening.

Keywords: acute medicine; infection; monoclonal gammopathy of undetermined significance; renal dysfunction; screening.

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References

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