Reform and reunion trends
Adoption practices have changed significantly over the course of the 20th century, with each new movement labeled, in some way, as reform. Beginning in the 1970s, efforts to improve adoption became associated with opening records and encouraging family preservation. These ideas arose from suggestions that the secrecy inherent in modern adoption may influence the process of forming an identity, create confusion regarding genealogy, and provide little in the way of medical history. Family preservation: As concerns over illegitimacy began to decline in the early 1970s, social-welfare agencies began to emphasize that, if possible, mothers and children should be kept together. In the U.S., this was clearly illustrated by the shift in policy of the New York Foundling Home, an adoption-institution that is among the countrys oldest and one that had pioneered sealed records. It established three new principles including "to prevent placements of children...", reflecting the belief that children would be better served by staying with their biological families, a striking shift in policy that remains in force today. In addition, groups such as Origins USA (founded in 1997) started to actively speak about family preservation and the rights of mothers. The intellectual tone of these reform movements was influenced by the publishing of The Primal Wound by Nancy Verrier. "Primal wound" is described as the "devastation which the infant feels because of separation from its birth mother.
There is a predominance of clonal plasma cells in the bone marrow with an abnormal immunophenotype (CD38+ CD56+ CD19−) mixed in with cells of a normal phenotype (CD38+ CD56− CD19+); in MGUS, on average more than 3% of the clonal plasma cells have the normal phenotype, whereas in multiple myeloma, less than 3% of the cells have the normal phenotype. Diagnosis
MGUS is a common, age-related medical condition characterized by an accumulation of bone marrow plasma cells derived from a single abnormal clone. Patients may be diagnosed with MGUS if they fulfill the following four criteria:
A monoclonal paraprotein band less than 30 g/L (< 3g/dL);
Plasma cells less than 10% on bone marrow examination;
No evidence of bone lesions, anemia, hypercalcemia, or chronic kidney disease related to the paraprotein, and
No evidence of another B-cell proliferative disorder. Differential diagnosis
Several other illnesses can present with a monoclonal gammopathy, and the monoclonal protein may be the first discovery before a formal diagnosis is made:

Multiple myeloma
Smouldering multiple myeloma
AIDS
Chronic lymphocytic leukemia
Non-Hodgkin lymphoma, particularly Splenic marginal zone lymphoma and Lymphoplasmocytic lymphoma
Hepatitis C
Connective tissue disease such as lupus
Immunosuppression following organ transplantation
Waldenström macroglobulinemia
Guillain–Barré syndrome
Tempi syndrome
POEMS

Management
The protein electrophoresis test should be repeated annually, and if there is any concern for a rise in the level of monoclonal protein, then prompt referral to a hematologist is required.