MGUS: Monoclonal Gammopathy of Uncertain Significance

[RoseBlood]

Please excuse me if I'm all over the place with this one:

I was talking to my mom's sister and she informed me she has MGUS, which is known to run in siblings. She found out a few years ago but we have not really spoken in 5yrs so I didn't know, but that's besides the point. I do not know if my mom has this but I do know she has a low red blood cell count. I also know my mom has a weakened immune system, so her white blood cell count has been known to be low as well. Both my aunt and mother have been tested for leukemia in the past (both negative).

What can you tell me about MGUS as it relates to a persons blood count. The reason I ask is because my mothers count is low (after 2 transfusions) and I don't know why. I was told that with MGUS, it's only dangerous if your white blood cell count is high. I am going to do some research of my own but wanted to ask you.

Thank You

[Dr Steve]

Please excuse me if I'm all over the place with this one:

I was talking to my mom's sister and she informed me she has MGUS, which is known to run in siblings. She found out a few years ago but we have not really spoken in 5yrs so I didn't know, but that's besides the point. I do not know if my mom has this but I do know she has a low red blood cell count. I also know my mom has a weakened immune system, so her white blood cell count has been known to be low as well. Both my aunt and mother have been tested for leukemia in the past (both negative).

What can you tell me about MGUS as it relates to a persons blood count. The reason I ask is because my mothers count is low (after 2 transfusions) and I don't know why. I was told that with MGUS, it's only dangerous if your white blood cell count is high. I am going to do some research of my own but wanted to ask you.

Thank You

Ok, MGUS is "Monoclonal Gammopathy of Uncertain Significance". A little background information is in order so we can all understand what we're talking about.

Your body makes a substance called "Gamma Globulin"...it's generally used to make antibodies against invaders, such as bacteria and viruses. You are making antibodies all the time for all kinds of things you've been exposed to in your life...each antibody is made by a subset of the antibody-producing cells in the body. Generally, you are in a "polyclonal" state, meaning there are roughly equal amounts of a jillion different antibodies running around in your body.

If one subset of cells starts producing a crap load of extra, unneeded gamma globulins, this will produce a "spike" of gamma globulin that can be detected by a test called "serum protein electrophoresis".

So what generally happens is, someone has a routine blood test that includes serum protein and albumin. You subtract the albumin level from the total protein level and this will give you an estimate of the total globulin level in the bloodstream. If it's elevated, they'll follow up with the serum protein electrophoresis. If there is a monoclonal spike and everything else is normal, the diagnosis of MGUS can be made.

80% of the time, nothing at all happens, ever. In 20% of cases, MGUS can progress to something more serious over the lifetime of the patient. This number is high enough that everyone with MGUS needs to see a hematologist (blood doctor) and be followed on a regular basis. The annual risk of MGUS becoming something more serious is like 1% (i.e., 99% of people do not progress in any given year).

Since the definition of MGUS includes the requirement that everything else be normal, it's unlikely that your mother has this. However, her low white count and low red count is of some concern. She needs to see a hematologist and see if they can make a definite diagnosis. Some people just have low white blood counts, but it can be a sign of a decline in function of the bone marrow that definitely needs attention by a specialist.

Hope this helps. Let me know if you need more info.


your friend,



Steve