What is monoclonal gammopathy of clinical significance?

What is monoclonal gammopathy of clinical significance? Monoclonal gammopathy of clinical significance is another new umbrella term that we're using when patients have an abnormal protein and abnormal plasma cells in the bone marrow that don't meet criteria for multiple myeloma, like an M-spike greater than 3 or greater than 10% plasma cells in the bone marrow. However, the problem seems to be causing problems. And so we're starting to see that protein could cause neuropathy or additional infections. And this is an area that's getting a little bit harder to determine. In my own practice, a lot of times a patient comes to me with a symptom and they have a monoclonal gammopathy. What we try and do first is make sure that that problem that they're having, such as neuropathy isn't caused by something else, like a history of diabetes, thyroid disease, low B12 or vitamin D levels. And then once we determine that we think that it's causing them a problem and that that's worth treating, then we go ahead and treat and see if their symptoms improve. How is monoclonal gammopathy of clinical significance managed? Patients with monoclonal gammopathy of undetermined significance are monitored. And what we're trying to learn is who are those patients that we need to monitor more carefully and more frequently because we think that their risk of developing a myeloma-related problem or enough myeloma to treat could be coming soon. What testing should be done if monoclonal gammopathy of clinical significance is suspected? It is like this that it depends on what you suspect. Sometimes the patients are not referred to our department. If you suspect a plasmasitoma that can cause neuropathy, for example, I think you will be, you need to do a PET CT and you also need to do the normal workup with bone marrow and blood samples. You need the biopsy from a plasmasitoma if that's the case. If you go to another entity like the amyloidosis, it requires collaboration with the colleagues from all over the hospital because this amyloid can be deposited in every organ and you need the standard workup for myeloma, but you may also need to make a biopsy from your heart, from the kidneys, from nerves maybe. You need to take certain kind of blood tests like vascular endothelial growth factors. When you have a disease that is related to cytokines like this, then there are other diseases that pones and you have to go through all organs in the body to make an assessment of these patients. Careful, careful, careful examination. And then there's treatment.