2015, Cilt 13, Sayı 3, Sayfa(lar) 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 |
Alev Kural1, Çağlar Helvacıoğlu2, Ekin Murat2, Tekin Neijmann Şebnem1 |
1Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya, İstanbul, Türkiye 2Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi, Kadın Doğum Kliniği, İstanbul, Türkiye |
Keywords: hCG, hemodialysis |
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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. |
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