Falsely elevated human chorionic gonadotropin leading to unnecessary therapy.
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.
Olsen
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TG
David Grant Medical Center, Travis Air Force Base, California, USA. tandyolsen@hotmail.com
Hubert
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PR
Nycum
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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
D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate