Postmenopausal pregnancy? Evaluation of elevated hCG in a 59-year-old woman

Basham, Mary Margaret; Bryan, T.

doi:10.1136/bcr-2016-218807

Cited by 3 publications

(6 citation statements)

References 9 publications

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“…Values of beta-hCG in the indeterminate (5-25 IU/L) or positive range (>25 IU/L) prompt additional workup to rule out pregnancy or malignancies [6]. Additionally, elevated serum beta-hCG has also been a reported finding in postmenopausal females, with 6%-8% having an increased value; however; it is not a well-known trend (Table 1) [7]. Early normal pregnancy >50…”

Section: Discussionmentioning

confidence: 99%

Elevated Beta-Human Chorionic Gonadotropin in a Non-pregnant Female With Altered Kidney Function

Ostreni¹,

Colatosti²,

Basile³

et al. 2022

Cureus

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Elevated beta-human chorionic gonadotropin (beta-hCG) levels in postmenopausal women is a finding known in the literature; however, it still commonly leads to unnecessary and extensive diagnostic workup. We present the case of a 48-year-old African-American postmenopausal female with acute kidney injury on chronic kidney disease (CKD) stage 5 and an incidental finding of elevated serum beta-hCG. Abdominal and transvaginal ultrasound showed no evidence of intrauterine or ectopic pregnancy or gestational trophoblastic disease. Menopausal status was confirmed with follicle-stimulating hormone (FSH) measurement, and following the improvement of renal status, beta-hCG levels were normalized to expected values for the patient's age group. The etiology of elevated beta-hCG was suspected to be from the pituitary as previous literature has shown decreasing beta-hCG levels in postmenopausal women following the administration of gonadotropin-releasing hormone (GnRH) antagonist.

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Section: Discussionmentioning

confidence: 99%

Elevated Beta-Human Chorionic Gonadotropin in a Non-pregnant Female With Altered Kidney Function

Ostreni¹,

Colatosti²,

Basile³

et al. 2022

Cureus

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“…Based on our knowledge and investigations, it seems that this case is the 745 th case of postmenopausal pregnancy reported in 1997–2018. [ 3 11 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] In a study, vaginal bleeding was only associated with elevated Human Chorionic Gonadotropin (HCG) hormone. [ 3 ] In another study leech infestation was reported as the cause of vaginal bleeding, and reviewing studies since 1990 revealed only 2 cases of postmenopausal vaginal bleeding due to leech infestation. [ 2 3 ] In the current case, 7 years after the onset of menopause, “the patient's history of AUB led to a request for an abdominal ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Postmenopausal pregnancy: A case report

Mirsafi

Attarha

2020

Iranian J Nursing Midwifery Res

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Abnormal vaginal bleeding is one of the complaints of women during menopause. Various diseases such as endometrial atrophy, polyps, and endometrial cancers may lead to postmenopausal vaginal bleeding. This report describes a case of postmenopausal vaginal bleeding caused by pregnancy. A 54-year-old woman referred to the prenatal clinic in Arak, Iran, with postmenopausal vaginal bleeding in 2018. Transabdominal ultrasound revealed an uterine pregnancy. At 28 weeks of gestation, she referred to the health center and her prenatal care began in the midwifery clinic. She gave birth to a baby girl at 34 weeks through a cesarian section. This case reminds practitioners and midwives that pregnancy may be one of the etiologies of postmenopausal vaginal bleeding especially in women with sexual activity. Therefore, a free beta-subunit human chorionic gonadotropin (HCG) hormone measurement should be conducted and if found to be elevated, followed by appropriate imaging tests.

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“…On the other hand, this elevation of βhCG in nonpregnant women, especially in women around menopause, often leads the clinicians as well as those women to confusion. Detectable hCG in nonpregnant, perimenopausal women should raise concern because it is present in conditions which are often very rare: gestational trophoblastic diseases, ovarian germ cell tumors, paraneoplastic syndrome of some neoplasms and pituitary secretion of hCG 2 . Last, a false‐positive pregnancy test due to heterophile antibodies should also be considered 1,2 .…”

Section: Introductionmentioning

confidence: 99%

“…Detectable hCG in nonpregnant, perimenopausal women should raise concern because it is present in conditions which are often very rare: gestational trophoblastic diseases, ovarian germ cell tumors, paraneoplastic syndrome of some neoplasms and pituitary secretion of hCG 2 . Last, a false‐positive pregnancy test due to heterophile antibodies should also be considered 1,2 . Here, we present the case of a 45‐year‐old amenorrheic woman with persistent elevation of serum βhCG levels, even after various interventions and cytostatic therapy.…”

Section: Introductionmentioning

confidence: 99%

Case report of persistent elevation of βhCG in a nonpregnant woman: A diagnostic puzzle

Bonaci-Nikolic

Rakic

Ardalić

et al. 2020

J of Obstet and Gynaecol

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Detectable serum levels of beta subunit of human chorionic gonadotropin (βhCG) in nonpregnant, perimenopausal women bring confusion in both clinician and patient and could lead to unnecessary diagnostic and therapeutic procedures. A 45‐year‐old woman with the continuous elevation of βhCG underwent hysteroscopy, two laparoscopic surgeries, two explorative uterine cavity curettages and three cycles of cytostatic therapy. No ultrasonographic, macroscopic or histological signs of pregnancy, both uterine and ectopic or gestational trophoblastic disease were found. Both radiographic and computed tomography reports ruled out the presence of a nongynecological neoplasm. All recommended steps were taken for confirmation or ruling out the possibility of heterophile antibodies interference, but the results were not absolute. Finally, the referent laboratory confirmed the presence of the antibodies, but their exact type remains unknown. This case underlines the importance of the universally accepted protocol in the cases of persistent βhCG elevation in nonpregnant, perimenopausal women.

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Postmenopausal pregnancy? Evaluation of elevated hCG in a 59-year-old woman

Cited by 3 publications

References 9 publications

Elevated Beta-Human Chorionic Gonadotropin in a Non-pregnant Female With Altered Kidney Function

Elevated Beta-Human Chorionic Gonadotropin in a Non-pregnant Female With Altered Kidney Function

Postmenopausal pregnancy: A case report

Case report of persistent elevation of βhCG in a nonpregnant woman: A diagnostic puzzle

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