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

Research output: Contribution to journalArticlepeer-review

External organisations

  • University Hospitals Birmingham NHS Foundation Trust

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.

Bibliographic note

Funding Information: We would like to acknowledge the patients, family members of patients and staff of the Queen Elizabeth Hospital Acute Medical Unit for supporting this study. We would also like to acknowledge the laboratory team at the Clinical Immunology Service, University of Birmingham for their help in analysing samples. This work was funded by a grant from the Experimental Cancer Medicine Centre, Birmingham, the Clinical Immunology Service at the University of Birmingham and an unrestricted grant from the University Hospitals Birmingham NHS Foundation Trust. Publisher Copyright: © 2020 British Society for Haematology and John Wiley & Sons Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

Details

Original languageEnglish
Pages (from-to)1127-1135
Number of pages9
JournalBritish Journal of Haematology
Volume189
Issue number6
Publication statusPublished - 1 Jun 2020

Keywords

  • acute medicine, infection, monoclonal gammopathy of undetermined significance, renal dysfunction, screening

ASJC Scopus subject areas