title: Falsely elevated human chorionic gonadotropin leading to unnecessary therapy.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Patients with histories incongruent with serum beta-hCG findings should have urine beta-hCG analysis.
authors.affiliation: David Grant Medical Center, Travis Air Force Base, California, USA. tandyolsen@hotmail.com
authors.forename: T G
authors.initials: TG
authors.lastname: Olsen
authors.forename: P R
authors.initials: PR
authors.lastname: Hubert
authors.forename: L R
authors.initials: LR
authors.lastname: Nycum
mesh_terms: D000293:Adolescent; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood* / Q000652:urine; D004107:Dilatation and Curettage; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D010298:Parity; D011247:Pregnancy; D019564:Unnecessary Procedures
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate