Core IM | Internal Medicine Podcast
#169 MGUS to Multiple Myeloma Diagnostics and Counseling: 5 Pearls Segment
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!
52:23
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Quick takeaways
- Monoclonal gammopathies, including MGUS and multiple myeloma, present with a varying clinical spectrum requiring careful diagnostic evaluation.
- SPEP, immunofixation, and serum-free light chain assays are crucial tests, each offering different insights into the nature of monoclonal proteins.
Deep dives
Understanding Monoclonal Gammopathies
Monoclonal gammopathies are relatively common, with approximately 5% of individuals over the age of 50 in the United States presenting with a monoclonal protein. This condition arises when plasma cells, which produce antibodies, become clones of each other and secrete a single type of antibody. The spectrum of monoclonal gammopathies ranges from benign conditions like monoclonal gammopathy of undetermined significance (MGUS) to malignancies such as multiple myeloma. Recognizing the prevalence and variations of monoclonal gammopathies is crucial for appropriate clinical suspicion and testing.
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