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

Monoclonal gammopathy of undetermined significance (MGUS) affects 3 center dot 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 center dot 3%. MGUS prevalence in those aged >50 years was 6 center dot 94%, higher than the previously published rate of 3 center dot 2% (P < 0 center dot 0005). There were higher rates in those with chronic kidney disease (13 center dot 75% vs. 4 center dot 14%, P = 0 center dot 002), heart failure (14% vs. 4 center dot 59%, P = 0 center dot 012), anaemia (8 center dot 96% vs. 3 center dot 41%, P = 0 center dot 003) or leucocytosis (9 center dot 33% vs. 3 center dot 04%, P = 0 center dot 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.