Kaur Jasneet, Valisekka Sai Sudha, Hameed Maha, Bandi Pushyami Satya, Varma Samyukta, Onwughalu Chibuzor Joseph, Ibrahim Hany, Mongia Himani
Internal Medicine, Nassau University Medical Center, East Meadow, New York, USA..
Internal Medicine, University of Minnesota, Minneapolis, USA.
Clin Lymphoma Myeloma Leuk. 2023 May;23(5):e195-e212. doi: 10.1016/j.clml.2023.02.004. Epub 2023 Feb 23.
Monoclonal Gammopathy of Undetermined Significance (MGUS) is an asymptomatic premalignant plasma cell dyscrasia with a predominate rise of the IgG immunoglobulin fraction without end-organ damage, often diagnosed incidentally. Despite its progression into various subsequent forms of hematological malignancies, MGUS remains underdiagnosed. A literature search was conducted using the Medline, Cochrane, Embase, and Google Scholar databases, including articles published until December 2022. Keywords used encompassed "Monoclonal Gammopathy of Undetermined Significance," "Plasma Cell dyscrasia," "Monoclonal gammopathy of renal significance," and "IgM Monoclonal gammopathy of Undetermined Significance," This study aimed to conduct a critical review to update knowledge regarding the pathophysiology, risk factors, clinical features, diagnostic protocols, complications, and current and novel treatments for MGUS. We recommend a multidisciplinary approach to manage MGUS due to the complexity of the illness's etiology, diagnosis, and therapy. This comprehensive review also highlights future prospects, such as developing screening protocols for at-risk populations, prevention of disease progression by early diagnosis through genome-wide association studies, and management using Daratumumab and NSAIDs.
意义未明的单克隆丙种球蛋白病(MGUS)是一种无症状的癌前浆细胞异常增殖性疾病,主要表现为IgG免疫球蛋白组分升高且无终末器官损害,常为偶然诊断。尽管MGUS可进展为各种后续形式的血液系统恶性肿瘤,但其仍未得到充分诊断。我们使用Medline、Cochrane、Embase和谷歌学术数据库进行了文献检索,包括截至2022年12月发表的文章。使用的关键词包括“意义未明的单克隆丙种球蛋白病”、“浆细胞异常增殖性疾病”、“具有肾脏意义的单克隆丙种球蛋白病”和“意义未明的IgM单克隆丙种球蛋白病”。本研究旨在进行批判性综述,以更新关于MGUS的病理生理学、危险因素、临床特征、诊断方案、并发症以及当前和新型治疗方法的知识。由于该疾病病因、诊断和治疗的复杂性,我们建议采用多学科方法来管理MGUS。这篇全面的综述还强调了未来前景,如为高危人群制定筛查方案、通过全基因组关联研究进行早期诊断以预防疾病进展,以及使用达雷妥尤单抗和非甾体抗炎药进行管理。