Journal of Turkish Clinical Biochemistry

The official publication of Turkish Society of Clinical Biochemistry

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December 01, 2015
JTCB. 2015 Dec 1; 13 (3) : 114-118
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Persistent Elevated β HCG in a Non Pregnant Patient with Chronic Renal Insufficiency. A rare case Leading a Misdiagnosis of Ectopic Pregnancy

1 Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya, İstanbul, Türkiye
2 Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Kadın Doğum Kliniği, İstanbul, Türkiye

Abstract

Background: Beta-human chorionic gonadotropin (beta-hCG) is secreted in small amounts by all cells and since the hormone is largely excreted by the kidneys, its levels can be elevated in non-pregnantdialysis patients.

Case presentation: A 27-year-old healthy multigravid woman was seen in our emergency department with a history of a higher β -hCG level. She had end-stage renal disease. Beta-hCG level was 180 mIU/mL. It was fitted for 2-3 weeks pregnancy according to reference interval.There were no differences between pre and post dialysis hCG levels. The analysis were performed using Beckman Coulter System (USA). In case of heterophile antibody the analysis repeated with dilution on different analysers. We found almost same β hCG results from three systems. Her β hCG levels were 90,76± 5,54 mIU/mL (mean ± SD) during 17 days lenght of stay at hospital. None of the radiodiagnostic tests either diagnosed a intrauterine or extrauterine pregnancy. We decided that this hCG levels were affected from dialysis.

Conclusions: We conclude that elevated β hCG values can be found in non pregnant women on chronic hemodialysis, erroneously indicating an early pregnancy or an extrauterine pregnancy. Since serum β hCG levels are not reliable in dialysis patients, the diagnosis should be confirmed by measuring serial β hCG levels.

Citation

Kural, Alev, Çağlar Helvacıoğlu, Ekin Murat, and Tekin Neijmann Şebnem. 2015. “Persistent Elevated β HCG in a Non Pregnant Patient With Chronic Renal Insufficiency. A Rare Case Leading a Misdiagnosis of Ectopic Pregnancy”. Journal of Turkish Clinical Biochemistry 13 (3):114-18. https://turkclinbiochem.org/index.php/pub/article/view/230.

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