Canterbury DHB
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The majority (72%) of patients with a new monoclonal protein will have MGUS. This is defined by the presence of a monoclonal protein of less than 30 g/L, a bone marrow plasma cell infiltrate of less than 10%, and the absence of anaemia, hypercalcaemia, lytic bone lesions, and renal failure attributable to a plasma cell disorder.
A detailed history and examination should include enquiry for symptoms associated with myeloma (bone pain), amyloid (heart failure, macroglossia, peripheral neuropathy, carpal tunnel syndrome, nephrotic syndrome) and lymphoproliferative diseases (night sweats, fevers, weight loss, lymphadenopathy, hepatosplenomegaly).
Patients with a new monoclonal protein should undergo initial testing including
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Topic Code: 39806
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