Management of Nonpregnant Women with Elevated Human Chorionic Gonadotropin

Bernd C Schmid,Martin K Oehler,Aimee Reilly

doi:10.1155/2013/580709

Abstract

Human chorionic gonadotropin (hCG) is useful in evaluating and monitoring early pregnancy as well as trophoblastic disease. Here we describe the management of women with elevated serum human chorionic gonadotropin in a case of a 51-year-old female who was unsuccessfully treated for ectopic pregnancy. She was subsequently diagnosed with pituitary hCG production, which should be considered as differential diagnosis before treatment is initiated.

Highlights

Human chorionic gonadotropin is useful in evaluating and monitoring early pregnancy as well as trophoblastic disease
She was subsequently diagnosed with pituitary Human chorionic gonadotropin (hCG) production, which should be considered as differential diagnosis before treatment is initiated
Human chorionic gonadotropin is a heterodimeric glycoprotein hormone composed of an α-chain and a β-chain. hCGα is essentially identical to that of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and thyroid-stimulating hormone (TSH), whereas the β-chains have greatly differing structures and are responsible for the respective specific hormonal functions and immunological specificity [7]

Summary

Management of Nonpregnant Women with Elevated Human Chorionic Gonadotropin

Human chorionic gonadotropin (hCG) is useful in evaluating and monitoring early pregnancy as well as trophoblastic disease. We describe the management of women with elevated serum human chorionic gonadotropin in a case of a 51-year-old female who was unsuccessfully treated for ectopic pregnancy She was subsequently diagnosed with pituitary hCG production, which should be considered as differential diagnosis before treatment is initiated. A 51-year-old parous woman presented with a history of intermittent pelvic cramps and vaginal spotting after two years of amenorrhoea following insertion of an etonogestrel implant for contraception She was found to have an elevated serum human chorionic gonadotropin (total β hCG (hCG + hCGβ)) measured via a quantitative electrochemiluminescence immunoassay “ECLIA” recognizing the holo-hormone, “nicked” forms of hCG, the β-core fragment, and the free βsubunit (Elecsys free β-hCG, Roche Diagnostics, Germany). To suppress pituitary hCG production the patient was placed on a combined oestrogen-progesterone hormone replacement therapy and after two weeks the serum hCG levels were found to be normal, measuring

Discussion

Findings

Conflict of Interests