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Tests and diagnosis
By Mayo Clinic staffMonoclonal gammopathy of undetermined significance is usually detected during a blood test for another condition or symptoms, such as a nerve condition called peripheral neuropathy or an unexplained rash. The test, called serum protein electrophoresis (SPE), separates your blood proteins into five parts and can show any abnormal proteins as well as unusual amounts of normal proteins. Another test, the free light chain assay, is often done at the same time as the SPE, and it looks at the smaller parts of the M protein.
If your doctor detects monoclonal gammopathy, further testing may be ordered to determine what M protein your body is making and how much is being made. Your doctor also works to rule out other causes of elevated protein levels. Tests may include:
- Blood tests. Tests to count the blood cells in your blood (complete blood count), to look for decline in kidney function (serum creatinine test) and to determine the amount of calcium in your blood (serum calcium test) can help rule out other types of monoclonal gammopathy, such as multiple myeloma.
- X-rays. X-rays help your doctor look for bone abnormalities that may indicate another type of plasma cell disorder.
- Bone marrow test. During a bone marrow test, your doctor uses a hollow needle to remove a portion of your bone marrow from the back of one of your hipbones. The bone marrow is then analyzed to determine what percentage of plasma cells it contains. This test is generally only done when doctors suspect that someone is at risk of developing a more serious disease, or in people with unexplained anemia, kidney failure, bone lesions or high calcium levels.
- Blade J. Monoclonal gammopathies of undetermined significance. New England Journal of Medicine. 2006;355:2765.
- Rajkumar SV, et al. Advances in the diagnosis, classification, risk stratification, and management of monoclonal gammopathy of undetermined significance: Implications for recategorizing disease entities in the presence of evolving scientific evidence. Mayo Clinic Proceedings. 2010;85:945.
- Rajkumar SV. Monoclonal gammopathy of undetermined significance. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2010.
- Monoclonal gammopathy of undetermined significance (MGUS). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec11/ch144/ch144d.html. Accessed Oct. 21, 2010.
- Wadhera RK, et al. Prevalence of monoclonal gammopathy of undetermined significance: A systematic review. Mayo Clinic Proceedings. 2010;85:933.
- Landgren O, et al. Obesity is associated with an increased risk of monoclonal gammopathy of undetermined significance among black and white women. Blood. 2010;116:1056.
- Mikhael JR (expert opinion). Mayo Clinic, Scottsdale, Ariz. Nov. 12, 2010.
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