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Obstetrics & Gynecology 2001;98:843-845
© 2001 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Falsely Elevated Human Chorionic Gonadotropin Leading to Unnecessary Therapy

Tandy G. Olsen, MD, Paula R. Hubert, MD and Lawrence R. Nycum, MD

David Grant Medical Center, Travis Air Force Base, California

Address reprint requests to: Tandy G. Olsen, MD, Department of OB/GYN, Landstuhl Regional Medical Center, CMR 402 Box 1176, APO AE 09180, Germany; E-mail: tandyolsen{at}hotmail.com.

BACKGROUND: Analysis of serum ß-hCG aids diagnosis and treatment of intrauterine pregnancies, ectopic gestations, and gestational trophoblastic neoplasia. ß-hCG concentrations are specific for trophoblastic tissue, thus are rarely questioned.

CASES: An 18-year-old nullipara had bleeding and a positive ß-hCG. Ultrasound identified no pregnancy. She passed tissue and stopped bleeding. Serum ß-hCG remained elevated despite uterine curettage and three courses of methotrexate. Results of urine ß-hCG were negative, as was reference laboratory serum assay. A 31-year-old nullipara had a spontaneous abortion, but serum ß-hCG remained elevated. Uterine curettage found secretory endometrium, yet elevated serum ß-hCG persisted. Urine ß-hCG was negative, as was reference laboratory serum assay.

CONCLUSION: Patients with histories incongruent with serum ß-hCG findings should have urine ß-hCG analysis.




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