“…The hCG level in the sample is then obtained by comparing the amount of tracer signal in the sample to a standard hCG concentration curve (Fig. 2A) (Griffey et al, 2013). Fig.…”
Section: Discussionmentioning
confidence: 99%
“…Fig. 2Sandwich assay schematic demonstrating a normal positive hCG test (A) where intact hCG molecule is recognized by both fixed and free-floating antibodies with a reporter label and a false negative hCG test due to the hook-effect (B) where excess hCG saturates both fixed and free-floating antibodies preventing sandwich formation (Griffey et al, 2013). …”
Section: Discussionmentioning
confidence: 99%
“…Since the non-sandwiched tracer antibodies are washed away with the excess material, the hCG test will be negative (Fig. 2B) (Griffey et al, 2013). The sensitivity of most hCG assays are set to the normal pregnancy hCG range at 8 to 11 weeks of about 25,000 to 250,000 mIU/mL.…”
HighlightsAt high hCG levels in molar pregnancies, a “hook effect” can cause an artificially negative value.Delay in diagnosis of a molar pregnancy due to the “hook effect” can lead to severe complications.Suspicion of a molar pregnancy should be communicated so a diluted sample is used to quantify hCG.
“…The hCG level in the sample is then obtained by comparing the amount of tracer signal in the sample to a standard hCG concentration curve (Fig. 2A) (Griffey et al, 2013). Fig.…”
Section: Discussionmentioning
confidence: 99%
“…Fig. 2Sandwich assay schematic demonstrating a normal positive hCG test (A) where intact hCG molecule is recognized by both fixed and free-floating antibodies with a reporter label and a false negative hCG test due to the hook-effect (B) where excess hCG saturates both fixed and free-floating antibodies preventing sandwich formation (Griffey et al, 2013). …”
Section: Discussionmentioning
confidence: 99%
“…Since the non-sandwiched tracer antibodies are washed away with the excess material, the hCG test will be negative (Fig. 2B) (Griffey et al, 2013). The sensitivity of most hCG assays are set to the normal pregnancy hCG range at 8 to 11 weeks of about 25,000 to 250,000 mIU/mL.…”
HighlightsAt high hCG levels in molar pregnancies, a “hook effect” can cause an artificially negative value.Delay in diagnosis of a molar pregnancy due to the “hook effect” can lead to severe complications.Suspicion of a molar pregnancy should be communicated so a diluted sample is used to quantify hCG.
“…Negative UPT with low β HCG on serum quantification should be further evaluated by sample dilution in patients with high suspicion of pregnancy 2. Cases have been reported where exclusion of pregnancy due to false negative UPT because of high-dose hook effect leads to initial misdiagnosis of a molar pregnancy as degenerative fibroid, delayed diagnosis or even death in cases of choriocarcinoma 2 3 6 7…”
A 22-year-old lactating mother presented with symptoms of uneasiness, palpitation, tachycardia and exophthalmos. She had an abdominal lump suggestive of 26 weeks uterine size but her urine pregnancy test was negative. Her thyroid profile was suggestive of hyperthyroidism. Gynaecological and ultrasonographic findings revealed a hydatidiform mole. She had a low β-human chorionic gonadotropin level that surprisingly increased after suction and evacuation. The paradoxical findings that appeared as erroneous laboratory results could be explained by the 'high-dose hook effect' after a review of literature. One week after the evacuation, the patient's thyroid profile and symptoms resolved completely without any treatment for hyperthyroidism.
“…Although the prevalence of these false negative results is unknown, it is clear that increased urine hCGcf concentrations can be observed during normal pregnancy. The use of such devices poses a risk to patients if treatment is inappropriately administered to pregnant women (4). In a recent study (3 ), we evaluated the susceptibility of 11 point-ofcare (POC) hCG devices to falsenegative results due to hCGcf.…”
is needed to derive more robust estimates for both the 99th and 97.5th percentiles. We hope that the IFCC task force will revisit the requirements for both the number of healthy individuals needed to determine the 99th percentile and which statistical tests may be used to assess potential outliers. In the meantime, the present data represent the first attempt to characterize hs-cTnI in healthy children from ages 1 through 18 years and should be of importance to the pediatric community at large.
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