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Abstract :
[en] Human Chorionic gonadotropin (hCG) is a complex glycoprotein with several bioactive forms. These five variants comprise placental forms (hyperglycosilated hCG is the first form, then after 10 weeks of pregnancy total hCG takes over), cancer promoter forms (hCGb, hyperglycosilated hCGb), and a pituitary form (sulfated hCG). Current routine laboratory tests do not discriminate between these multiple variants of hCG. Low persistent detectable levels of hCG may be associated with various benign and malignant conditions, such as quiescent gestational trophoblastic disease, raised pituitary hCG, or false positive elevation caused by circulating heterophilic antibodies. Clinico-biological discussion are mandatory to avoid erroneous
diagnosis and treatment.In this review we summarize and discuss the different causes of false positive hCG assay. We suggest that current gynecological protocols for the diagnosis and treatment of trophoblastic disease should consider the inclusion of hCG test in urine and/or a test for heterophilic antibodies, when appropriate to avoid unnecessary studies and treatment.
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& H. Valdes-Socin. Persistent low levels of serum hCG due to heterophilic mouse antibodies: an unrecognized pitfall in the diagnosis of trophoblastic disease . Gynecological Endocrinology 2016. DOI:10.3109/09513590.2015.1132303