False-negative qualitative human chorionic gonadotropin (hCG) test result ('hook effect') with classical ultrasound findings of complete molar pregnancy: an uncommon case.

Autor: Phillipo D; Médecins Sans Frontières Geneva, Nduta Project, Kigoma, Tanzania., Lucas S; Médecins Sans Frontières Geneva, Nduta Project, Kigoma, Tanzania., Kalunga MP; Médecins Sans Frontières Geneva, Nduta Project, Kigoma, Tanzania., Inyasi E; Médecins Sans Frontières Geneva, Nduta Project, Kigoma, Tanzania., Lebba JP; President's Office, Region Authorities and Local Governments, Region Health Management Team, Kigoma, Tanzania., Sudai FM; President's Office, Region Authorities and Local Governments, Region Health Management Team, Kigoma, Tanzania.; Ministry of Health, Maweni Regional Referral Hospital, Kigoma, Tanzania., Bizimana JK; Médecins Sans Frontières Geneva, Sexual Reproductive Health (SRH) Headquarter, Geneva, Berlin Medical Unit/MSF Germany.
Jazyk: angličtina
Zdroj: Oxford medical case reports [Oxf Med Case Reports] 2024 Jan 27; Vol. 2024 (1), pp. omad147. Date of Electronic Publication: 2024 Jan 27 (Print Publication: 2024).
DOI: 10.1093/omcr/omad147
Abstrakt: False-negative qualitative Human Chorionic Gonadotropin (hCG) result is a phenomenon in which large amounts of β-hCG are produced by molar pregnancy, oversaturating the test's assay system and leading to false-negative results known as the 'prozone phenomenon' or the 'hook effect'. This can lead to misdiagnosis and delay in management despite high suspicious clinical and ultrasound findings. We report a case of an 18-year-old female who presented to our health facility with amenorrhea of 16 weeks, lower abdominal pain, soft and large fundal height for gestational age, and cramping with slight per-vaginal bleeding, and a negative urinary pregnancy test (UPT). Based on clinical presentation, ultrasound findings and a positive UPT after urine dilution, molar pregnancy was diagnosed. Aspiration was performed under ultrasound guidance, and follow-up was done as per MSF guidelines. HCPs need to be familiar with some rare cases for which the possibility of finding false-negative UPT is likely.
Competing Interests: The authors declare no conflicts of interest.
(© The Author(s) 2024. Published by Oxford University Press.)
Databáze: MEDLINE
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