Journal article
Amenorrhea and pituitary human chorionic gonadotrophin production in a 38-year-old presenting as pregnancy of unknown location: case report and review of literature
Proceedings in obstetrics and gynecology, Vol.11(1), pp.1-11
02/11/2022
DOI: 10.17077/2154-4751.31138
Abstract
Background: Amenorrhea and extraplacental production of serum human chorionic gonadotropin (hCG), particularly in young women, can mimic a pregnancy of unknown location. Elevated serum hCG in the absence of pregnancy can pose a diagnostic dilemma and has led to potentially harmful and unwarranted interventions including chemotherapeutic agents like methotrexate or have led to delay in necessary medical interventions in women. We report a case to demonstrate that amenorrhea and extraplacental human chorionic gonadotropin (hCG) production in young women can mimic a pregnancy of unknown location. Furthermore, we performed a critical review of literature on pituitary hCG production. Case: A 38-year-old woman with a diagnosis of Silver-Russell syndrome, a unicornuate uterus, history of right oophorectomy for a benign serous cystadenoma and a desire for pregnancy presenting with a provisional diagnosis of pregnancy of unknown location.After performing a thorough review of history, physical examination, ultrasound exams, and a review of hormone analysis [including hCG, Tumor markers, Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Anti-Mullerian Hormone (AMH), Estradiol (E2) levels], we confirmed the diagnosis of premature ovarian insufficiency and pituitary hCG production. Conclusions: In women, serum levels of hCG may increase with age, and are not always an indicator of pregnancy. Therefore, it is imperative to interpret false-positive test results and rule out the extraplacental production of hCG. This will help prevent unnecessary surgical procedures and treatment, including chemotherapy.
Details
- Title: Subtitle
- Amenorrhea and pituitary human chorionic gonadotrophin production in a 38-year-old presenting as pregnancy of unknown location: case report and review of literature
- Creators
- Theadora Ordog - University of IowaMarika Rebecca Raff - Roy J. and Lucille A. Carver College of MedicineMary B. Rysavy - University of IowaEyup Hakan Duran - University of IowaJames R. Scott - University of IowaAbey Eapen - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Proceedings in obstetrics and gynecology, Vol.11(1), pp.1-11
- DOI
- 10.17077/2154-4751.31138
- ISSN
- 2154-4751
- eISSN
- 2154-4751
- Language
- English
- Date published
- 02/11/2022
- Academic Unit
- Obstetrics and Gynecology; Internal Medicine
- Record Identifier
- 9984317116702771
Metrics
2 Record Views