Known complications of MGUS, with relative risk compared with population, proposed underlying mechanism and available treatment optionsa
| Complication | Risk compared with population | Suggested pathological mechanism | Potential treatment |
|---|---|---|---|
| Fracture14 | 1.7 | Increased osteoclast activity and bone resorption15–18 | Bone protection with bisphosphonates |
| Osteoporosis19 ,20 | 1.2 (or higher) | ||
| Infection21,22 | 2.2 | Hypogammaglobulinaemia21
Reduction in specific antibody23 | Early treatment of infective symptoms; vaccinations |
| Renal disease 24,25 | Monoclonal Ig deposition disease,24 –26 proliferative glomerulonephritis,27 light-chain proximal tubulopathy 28 | Dependent on mechanism: chemotherapy | |
| Neuropathy 19,29 | 5.9 (CIDP) 3.2 (autonomic) | Antibodies against myelin-associated glycoprotein (MAG) in myelin sheath of peripheral nerves 30 | IV immunoglobulin; chemotherapy; rituximab (in clinical trials) |
| Thrombosis 31 | 2.1 | Inflammation related: raised inflammatory mediators, including IL-6 32 | Consideration of thromboprophylaxis in high-risk situations |
aThe known complications of MGUS, with relative risk compared with the general population given where available from current studies (as referenced) and treatment options.