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MGUS Monitoring — RACP Adult Medicine MCQ

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EasyHaematologyMGUS MonitoringRACP Adult Medicine

A 55-year-old woman has an incidental IgG lambda paraprotein of 8 g/L. FBE, calcium, creatinine, and skeletal survey are all normal. Bone marrow shows 3% plasma cells. Free light chain ratio is normal. What is the most important investigation for ongoing monitoring?

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Correct answer: E — Serum protein electrophoresis (SPEP)

MGUS requires annual monitoring with SPEP (to track the paraprotein level), FBE, calcium, creatinine, and serum free light chains. A rising paraprotein level may indicate progression to myeloma or related disorder. The risk of progression is approximately 1% per year. Immunofixation is done at baseline but not routinely for monitoring.

Reference: IMWG – 2024 – MGUS Monitoring; BSH 2024