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MGUS — RACP Adult Medicine MCQ

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EasyHaematologyMGUSRACP Adult Medicine

A 72-year-old woman has an incidental IgG kappa paraprotein of 12 g/L. Bone marrow shows 4% plasma cells. There is no anaemia, hypercalcaemia, renal impairment, or bone lesions. Free light chain ratio is normal. What is the most likely diagnosis?

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Correct answer: D — MGUS

Paraprotein <30 g/L with <10% bone marrow plasma cells and no CRAB features or myeloma-defining events is consistent with MGUS. The risk of progression to myeloma is approximately 1% per year. Follow-up with annual serum protein electrophoresis and FBE is recommended. No treatment is required.

Reference: IMWG – 2024 – MGUS Risk Stratification; BSH 2024