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A case of consistent discrepancies between urine and blood human chorionic gonadotropin measurements
-
Arjan Albersen
,
Evelien Kemper-Proper
Published/Copyright:
March 17, 2011
Abstract
Background: Our laboratory was confronted with two successive urine samples from a single patient which tested positive for human chorionic gonadotropin (hCG) when tested with both qualitative and quantitative assays, combined with no detectable hCG in corresponding plasma samples.
Methods: Serial dilution and recovery experiments were performed in order to investigate the presence of interfering substances or a high-dose hook effect. The ovarian cysts that were removed from this patient were immunohistochemically stained using polyclonal anti-human hCG antibodies. Furthermore, a urine sample was sent to the USA hCG Reference Service for hCG variant analysis.
Results: Dilution and recovery experiments in urine and plasma samples were unremarkable. The biopsy stained negative for human hCG and free β-subunit. hCG isoform analysis in the urine sample revealed that approximately 87.5% of the immunoreactive hCG lacked the β-subunit C-terminal peptide (CTP).
Conclusions: We report a rare case in which two successive urine samples test positive for hCG whereas in corresponding plasma samples hCG is undetectable. The majority of the total hCG contained a degraded form of β-subunit that lacks the CTP. This hCG variant, possibly of pituitary origin, is thought to have an extreme fast clearance rate possibly explaining the discordance between the hCG results in urine and plasma samples.
Received: 2010-9-15
Accepted: 2011-1-9
Published Online: 2011-03-17
Published in Print: 2011-06-01
©2011 by Walter de Gruyter Berlin Boston
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Keywords for this article
chorionic gonadotropin;
false-positive reactions;
point-of-care systems;
pregnancy tests
Articles in the same Issue
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- CCLM Award for The Most Cited Paper Recently Published
- Reviews
- Some views on proteomics in diabetes
- Cancer biomarkers for hepatocellular carcinomas: from traditional markers to recent topics
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- Low-density lipoprotein receptor-related protein 1: new functions for an old molecule
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- Opinion Paper
- Focusing on the clinical impact of standardization of creatinine measurements: a report by the EFCC Working Group on Creatinine Standardization
- General Clinical Chemistry and Laboratory Medicine
- Use of a fully automated immunoassay for celiac disease screening in a pediatric population
- Evaluation of four commercial biuret reagent kits of serum total protein by the American Association for Clinical Chemistry reference measurement procedure
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- Perchlorate (Irenat®) may falsely lower measured ionised calcium
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