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MGUS Blood Clots?
MGUS blood clots is slang for monoclonal gammopathy of thrombotic significance- yet another symptom of this “asymptomatic” blood disorder with the general name monoclonal gammopathy of clinical significance (MGCS).
The different types of MGCS listed below are significant because for as long as I can remember (30 plus years) people being diagnosed with MGUS were told that their blood disorder we asymptomatic aka any symptoms the patient was experiencing could not result from their diagnosis of monoclonal proteins.
We now know that this was simply incorrect information.
What is MGCS? How is it diagnosed?
What are the different diagnoses that fall under monoclonal gammopathy of clinical significance?
1. Hematologic MGCS
- Monoclonal gammopathy of undetermined significance (MGUS) with evolving complications:
- Progression to multiple myeloma, amyloidosis, or other plasma cell dyscrasias.
- Thrombotic events or recurrent infections related to hypogammaglobulinemia.
2. Renal MGCS (MGRS)
- Monoclonal Gammopathy of Renal Significance (MGRS):
- Renal impairment or disease caused by monoclonal immunoglobulins:
- Light chain deposition disease (LCDD).
- Light chain amyloidosis (AL amyloidosis).
- C3 glomerulopathy with monoclonal gammopathy.
- Proliferative glomerulonephritis with monoclonal IgG deposits.
- Renal impairment or disease caused by monoclonal immunoglobulins:
3. Neurologic MGCS
- Neuropathy-associated MGUS:
- Peripheral neuropathy linked to IgM monoclonal gammopathy (often anti-MAG antibodies).
- Chronic inflammatory demyelinating polyneuropathy (CIDP) associated with monoclonal proteins.
4. Dermatologic MGCS
- Monoclonal gammopathy-associated skin disorders:
- Scleromyxedema.
- Necrobiotic xanthogranuloma.
- Schnitzler syndrome (characterized by urticaria and systemic inflammation).
5. Cardiac MGCS
- Monoclonal protein-driven cardiac involvement:
- AL amyloidosis affecting the heart.
- Restrictive cardiomyopathy due to amyloid deposits.
6. Ophthalmologic MGCS
- Monoclonal gammopathy-associated ocular disorders:
- Depositions affecting the cornea or retina, such as paraproteinemic keratopathy.
7. Other Organ-Specific MGCS
- Hepatic MGCS:
- Liver dysfunction or damage linked to monoclonal protein deposition.
- Rheumatologic MGCS:
- Conditions like cryoglobulinemia-related vasculitis or connective tissue disease.
If you hear sarcasm in my voice it is because I am a long-term MM survivor and I have watched many people suffer from “experts” telling them that they are not suffering from their monoclonal proteins.
Email me at David.PeopleBeatingCancer@gmail.com with questions about MGCS.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Monoclonal Gammopathy of Thrombotic Significance
Simple Summary- It is being increasingly recognized that patients with monoclonal gammopathy (MG) who do not meet criteria for malignant disease and treatment initiation may have other manifestations that are linked to the unique properties of the monoclonal protein that are clinically significant and could provide a rationale for treatment.
It has been recognized that patients with MG are at higher risk for thrombosis and a number of rare entities that include venous, arterial and micro-thrombotic events have been described.
The hemostatic profile of patients with MG has not been ascertained yet and the major challenge is to identify patients with MG at high risk for thrombotic events and apply appropriate preventive measures.
We propose a new umbrella term, monoclonal gammopathy of thrombotic significance, that creates a link between the M-protein and thrombotic events, posing the question of whether treatment initiation and/or long term anticoagulation is indicated for these, otherwise asymptomatic patients.
Conclusions-What is undoubtedly clear, based on currently available evidence, is that the thrombotic risk in patients with MGUS shows significant heterogeneity. A subset of MGUS patients, who are otherwise asymptomatic and do not meet criteria for treatment initiation, seem to have clinically significant thrombotic manifestations.
The M-protein can have distinct prothrombotic properties like that of a cryoprotein or of an antibody with antiphospholipid activity, and could be the missing link in these patients, particularly in a context of unexplained, recurrent, or even catastrophic thrombotic events.
We propose a new term for these entities, monoclonal gammopathy of thrombotic significance, which expands further the list of syndromes that fall under the umbrella term monoclonal gammopathy of clinical significance.
The challenge remains to distinguish the high-risk patients for this entity among MGUS patients, using biomarker fingerprinting along with clinical profiling. Diagnosis should be considered after ruling out other common conditions related to thrombosis and requires establishing a link between thrombotic events and M-protein.
The presence of thrombotic events with severe presentation, recurrent character, in unusual sites, in both arterial and venous vascular beds, or associated to thrombosis in microcirculation (skin, renal thrombosis) should raise suspicion for syndromes that meet the criteria for monoclonal gammopathy of clinical significance and should pull the trigger for testing for cryoproteins, APL antibodies and autoimmune HIT.
Patients with monoclonal gammopathy of thrombotic significance should be candidates for treatment initiation directed against the plasma cell clone to eliminate the monoclonal protein, which initiates the processes that eventually result in thrombotic events.”
MGUS blood clots MGUS blood clots