I have MGUS and noticed low Hb and WBC. Please help.

Question

Hello doctor,

I was diagnosed with MGUS earlier this year. My lab report states immunoglobulin M33, lambda free light chains 19.74, kappa or lambda light chain ratio 0.07. My doctor said there is a faint spike. Black bar on a grey background and to come back in a year. I have noticed that most of my blood tests this year with other doctors reveal low WBC and hemoglobin. I have also noticed low monocytes and neutrophils over time. I was also diagnosed with small nerve fiber neuropathy earlier this year and had carpal tunnel surgery a few months back.

Answer 1

Hello,

Welcome to icliniq.com.

You have been diagnosed with MGUS problem (monoclonal gammopathy of undetermined significance). For that, no treatment has to be done except clinical monitoring. You are advised to investigate with serum urea, creatinine estimation, urine Bence Jones protein estimation to rule out kidney damage. Serum calcium also to be checked to determine how much osteolysis present. If needed, a CT scan can be done.

I suggest you consult a hematologist for your examination and monitoring every six months. If needed, the doctor will investigate with bone marrow aspiration study. For peripheral neuropathy, physiotherapy and multivitamin syrup can be prescribed. If neuropathic pain present, then pregabalin can be prescribed. For that problem, you can consult an orthopedic surgeon for the examination.