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Dr Khan
Dr Khan, Doctor
Category: Medical
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Experience:  MB, MRCP(UK), MCPS(Medicine)
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what is Monoclonal Paraproteinemia, Gammopathy Dx 273.1

Customer Question

what is "Monoclonal Paraproteinemia, Gammopathy" Dx 273.1 It was the Dx on my labwork they gave me to take to the lab.
I have Adrenal Insufficiency and am so tired all the time. Is this fatigue related?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr Khan replied 3 years ago.

Hello and Welcome to JA
Thank you very much for your question and coming to this service

well I would like to know a bit about your previous and current medications and for how long have you been taking those?

Any other diagnosed medical condition?

Can you please explain numbers in your question in more details?

Customer: replied 3 years ago.

 

meds: Plaquinil, for arthritis, Hydrocortisone 10- 15 mg for Adrenal insuff, (all studies come back "none detected" but it is not primary). fentanyl patch 25 mg q 3 days for chronic neck pain and muscle spasms due to car accident ruptured and bulging discs in neck, and Skelaxin at hs for same. Rest are due to allergies: Allegra, Singulair,OTC allergy eye drops,; celexa, 40 mg, standard for chronic illnesses. Also Forteo for severe osteoporosis with 6 bone breaks in 7 months, foot ,wrist, ribs x3, other foot, without injury to areas, ideopathic. Have steroid induced diabetes, take metformin. Fatigue started before all these meds though. Have been taking them for about 2 years. Fatigue started about 4 years ago, had to take Provigil for a while before driving or I would fall asleep on the way to or home from work. They stopped it when adrenal insuff diagnosed.

Expert:  Dr Khan replied 3 years ago.

What do you exactly mean by the number 273.1?

What do they reefer to?

Are you taking 10-15mg hydrocortisone right from beginning and as i perceive it made no difference to your fatigue. Is that right?

Customer: replied 3 years ago.

273.1 was the dx number , I assume, behind the monoclonal paraproteinemia, Gammopathy, (273.1)

The hydrocortisone has been some help, but resting has been the most help. I was told by my doc to take 90 days off work, and I slept most of that time. Now I'm back to work and having a tough time with fatigue. I had been taking cortisone for about 6 months, but it caused weight gain, then he changed it to hydrocortisone, taking for about 2 years now. The endocrinologist prescribed it.

Expert:  Dr Khan replied 3 years ago.

Thank you very much for all the details and my apologies for
some delay in replying as there was some internet glitch
Well MGUS (Monoclonal Gammopathy) is a condition in which there is high level of Immunoglobulin or M protein (simply you can take it as high protein levels) in blood or urine without evidence of related same cell types cancer like Multiple Myeloma

Per se it is a benign condition in a way that it does not cause any complications related to myeloma like bone damage or kidney failure

Due to high protein levels in blood it causes sluggish flow in vessels and has been known to be associated with fatigue and thrombosis(clot) due to poor circulation

However it needs to be followed up as it has got some tendency to evolve into myeloma and other cancers though the rate of conversion is quite low(Around 1% for most types

Treatment is just watchful observation and no real drugs are given

So your fatigue seems related to MGUS compounded by adrenal insufficiency

Only preventive measure being just to keep yourself well hydrated typically around 4 lit/day to avoid thickening of blood

This article,though a bit more medical will help you for knowledge

http://emedicine.medscape.com/article/204297-overview

Please let me know if there are any more queries

Warm Regards

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