What is the treatment for MGUS with severe vitamin D deficiency and hypothyroidism?
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I have MGUS, severe vitamin d deficiency , thyroid - hypo, and asthma. Recently have been sick a lot. My M-protein is 1.3 and my free light chain Kappa is 11 and Lambda is 49.9 my ration is of course abnormal. I have had two bone marrow biopsies over the last 10 years, the last one in 2006. Other the myeloma should I be looking at other diseases to discuss with my doctors?
Posted Fri, 27 Dec 2013 in Medicines and Side Effects
Answered by Dr. Shafi Ullah Khan 6 hours later
Brief Answer: Needs alot of surveillance and care Detailed Answer: hello Miss XXXX! Thank you for asking. I am sorry for so much troubles you have, Now as per your question of other than myeloma what you need to discuss with your doctor. i want you to know that MGUS is a blood cell dyscrasia and it does not need any treatment just surveillance but the progression is rapid and lymphoproliferative disorders can result like Amyloidosis, WM( Waldenstorm Macroglobulinemia) Lymphomas. MM (multiple lyeloma) or any other malignant lymphoproliferative disorder. So you need to discuss all the pros and cons of your prognostic factors with your doctor and the odds of this progression which according to your ratio and other associated morbidities and advanced age are very high. One more thing which you should discuss with your Doctor is the odds of Venous thromboembolism which are ery high in MGUS patients and a mild immobility or low albumin levels or increased leukocyte count or history in family can trigger in no time so need a constant monitoring. Your blood profile specially Vitamin B12 and folate levels and hypercoagulation profile needs alot of scrutiny and regular monitoring. So does the urine have 3 monthly 24 hour urine analysis to save and protect the Kidneys as they can easily get fried from a little progression. One more thing you need to discuss with your doctor is the odds of polyneuropathy as they are very much in MGUS patients and very disabling. And if developed or developing needs a treatment with rituximabs, cyclophosphamides, prednisones, or fludarabin therapies depending upon the doctors choice. I recommend rituximabs as they have little side effects compared to others. Now once you have discussed the odds of MGUS with your doctor don't forget to manage other load of pathologies you have . Treat your kidney infections, monitor them, Check on your platelets, Lipoma tumor is innocuous no worries, do supplement vitamin D as it decides many fates here, treat hypothyroidism manage a euthyroid state, Constant hypertension control with modification of lifestyles and diets and last but not the least Asthma which needs a constant care. Good Luck and i hope i was of some help. if you have any more queries for me, please feel free to ask other wise i request you to kindly close the discussion and rate the answer as per your experience. Take some very good care of yourself. And may the Odds be always in your favor. Regards Dr. S Khan