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Falsely elevated human chorionic gonadotropin leading to unnecessary therapy
T G Olsen1, P R Hubert, L R Nycum
1David Grant Medical Center, Travis Air Force Base, California, USA. tandyolsen@hotmail.com
Background:
Analysis of serum beta-hCG aids diagnosis and treatment of intrauterine pregnancies, ectopic gestations, and gestational trophoblastic neoplasia. beta-hCG concentrations are specific for trophoblastic tissue, thus are rarely questioned.
Cases:
An 18-year-old nullipara had bleeding and a positive beta-hCG. Ultrasound identified no pregnancy. She passed tissue and stopped bleeding. Serum beta-hCG remained elevated despite uterine curettage and three courses of methotrexate. Results of urine beta-hCG were negative, as was reference laboratory serum assay. A 31-year-old nullipara had a spontaneous abortion, but serum beta-hCG remained elevated. Uterine curettage found secretory endometrium, yet elevated serum beta-hCG persisted. Urine beta-hCG was negative, as was reference laboratory serum assay.
Conclusion:
Patients with histories incongruent with serum beta-hCG findings should have urine beta-hCG analysis.