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MGUS Bone Involvement?
How is MGUS bone involvement measured and tracked? Meaning, if an MGUS patient has a serum calcium level above normal, what does it mean?
According to the study linked below, of the more than 75,000 patients screened for hypercalcemia in the iSTOPMM study, 7.5% exhibited hypercalcemia at least once. That is a lot of hypercalcemia. Yet only 3 patients of those patients with hypercalcemia progressed to frank multiple myeloma.
While MM may not be the main concern of MGUS patients who develop hypercalcemia, these patients may develop other health challenges listed below.
What health challenges can be caused by hypercalcemia?
1. Kidney Issues
- Kidney Stones: Excess calcium can lead to the formation of kidney stones.
- Nephrocalcinosis: Deposits of calcium in the kidneys, impairing their function.
- Kidney Failure: Chronic hypercalcemia may damage the kidneys over time.
2. Bone Problems
- Bone Pain and Weakness: Elevated calcium levels are often due to bone resorption, leading to weaker bones and fractures (osteoporosis or osteopenia).
3. Neurological Effects
- Fatigue and Weakness: Common symptoms of high calcium levels.
- Confusion and Memory Loss: Calcium imbalance can affect brain function.
- Depression: Mood changes may occur.
- Severe Cases: Coma or impaired consciousness in extreme hypercalcemia.
4. Cardiovascular Issues
- Arrhythmias: Abnormal heart rhythms due to disrupted electrical activity.
- Hypertension: High calcium may contribute to elevated blood pressure.
- Calcification of Blood Vessels: Long-term hypercalcemia can cause calcium deposits in the arteries.
5. Digestive System Problems
- Nausea and Vomiting: Common initial symptoms.
- Constipation: Elevated calcium can slow intestinal motility.
- Pancreatitis: High calcium levels may trigger inflammation of the pancreas.
6. Muscular Symptoms
- Muscle Weakness: Interference with neuromuscular activity can lead to weakness.
- Cramps or Spasms: Rare, but possible in some cases.
Causes of Hypercalcemia:
- Overactive parathyroid glands (primary hyperparathyroidism).
- Certain cancers (e.g., lung, breast, or multiple myeloma).
- Excessive vitamin D or calcium intake.
- Prolonged immobilization (causing bone calcium release).
- Certain medications (e.g., thiazide diuretics, lithium).
Hypercalcemia in Individuals with MGUS: Results from the iStopMM Study
I guess what the study below is pointing out is that like the presence of “monoclonal proteins” a finding of excess protein can mean many different things. Yes, any diagnostic test that identifies a level above or below normal can be stressful.
But in the case of a finding of hypercalcemia, MGUS patients should undergo additional testing to identify the root cause of the reason why.
I am a long-term MM survivor and MM cancer coach. Email me at David.PeopleBeatingCancer@gmail.com with questions about pre-myeloma or full myeloma.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Approaching Hypercalcemia in Monoclonal Gammopathy of Undetermined Significance: Insights from the iStopMM study
Key Points
- Hypercalcemia in MGUS rarely indicates progression to multiple myeloma; no isolated hypercalcemia indicating progression was observed.
- Hypercalcemia cases in MGUS had similar causes to those in the general population. The approach to isolated hypercalcemia should be general.
- primary hyperparathyroidism (56.0%)
- and malignancies other than MM (16.0%).