Table 1.

Known complications of MGUS, with relative risk compared with population, proposed underlying mechanism and available treatment optionsa

ComplicationRisk compared with populationSuggested pathological mechanismPotential treatment
Fracture141.7Increased osteoclast activity and bone resorption15–18Bone protection with bisphosphonates
Osteoporosis19 ,201.2 (or higher)
Reduction in specific antibody23
Early treatment of infective symptoms; vaccinations
Renal disease 24,25Monoclonal Ig deposition disease,24 –26 proliferative glomerulonephritis,27 light-chain proximal tubulopathy 28Dependent on mechanism: chemotherapy
Neuropathy 19,295.9 (CIDP) 3.2 (autonomic)Antibodies against myelin-associated glycoprotein (MAG) in myelin sheath of peripheral nerves 30IV immunoglobulin; chemotherapy; rituximab (in clinical trials)
Thrombosis 312.1Inflammation related: raised inflammatory mediators, including IL-6 32Consideration 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.