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False positive hCG testing and upper urinary tract infection
Joris R Delanghe1, Valerie Pede1, Sylvie Mulliez1
1Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium.
Hormone Molecular Biology and Clinical Investigation
|March 2, 2025
Summary
False-positive human chorionic gonadotropin (hCG) results can occur in patients with urinary tract infections. Uromodulin interference in urine, linked to infection severity, is identified as the cause.
Area of Science:
- Clinical Chemistry
- Urology
- Biochemistry
Background:
- Human chorionic gonadotropin (hCG) assays are standard for pregnancy testing.
- False-positive hCG results were observed in patients with urinary tract infections (UTIs).
Purpose of the Study:
- To investigate the cause of false-positive hCG results in patients with UTIs.
- To identify the interfering substance responsible for inaccurate hCG measurements.
Main Methods:
- Excluded ectopic hCG production and heterophilic antibodies as causes.
- Utilized Orbitrap mass spectrometry to analyze urine samples.
- Correlated hCG levels with urinary alpha 1 microglobulin and leukocyte counts.
Main Results:
- Orbitrap mass spectrometry identified uromodulin, a urinary glycoprotein, as the interfering substance.
- False-positive hCG levels correlated with urinary alpha 1 microglobulin and leukocyte counts.
- The false positive hCG signal resolved after antibiotic treatment.
Conclusions:
- Uromodulin interference in urine is a likely cause of false-positive hCG tests in patients with upper UTIs.
- Urinary tract infections can lead to inaccurate hCG test results due to protein interference.
