Core IM | Internal Medicine Podcast #169 MGUS to Multiple Myeloma Diagnostics and Counseling: 5 Pearls Segment
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Jan 22, 2025 Join Dr. Aaron Goodman, a hematology oncologist from UC San Diego, and Dr. Vincent Rajkumar, an expert in multiple myeloma, as they delve into the complexities of monoclonal gammopathies. They clarify the roles of SPEP and immunofixation in diagnosis. Listeners will learn about the continuum from MGUS to multiple myeloma and the importance of urine testing. The discussion also tackles the clinical significance of symptoms in renal, neurologic, and dermatologic contexts. Key insights into patient counseling round out this informative conversation!
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Monoclonal Gammopathy Spectrum
- Monoclonal gammopathy is a clonal population of plasma cells producing one antibody type.
- This ranges from benign, age-related MGUS to malignant plasma cell myeloma.
SPEP Ordering
- Order SPEP when suspecting multiple myeloma or related disorders, not routinely.
- Routine SPEP orders lead to positive results requiring further interpretation, creating confusion.
Plasma Cell Disorder Clues
- Consider plasma cell disorders in hypercalcemia, especially with lytic bone lesions.
- Unexplained renal failure with high calcium, granular casts, or high urine protein may also signal it.