Phantom Human Chorionic Gonadotropin in an End Stage Renal Disease Case
Buket Kin Tekce *
Department of Medical Biochemistry, Abant Izzet Baysal University, Faculty of Medicine, 14280, Bolu, Turkey.
Hikmet Tekce
Department of Nephrology, Abant Izzet Baysal University, Faculty of Medicine, 14280, Bolu, Turkey.
Gulali Aktas
Department of Internal Medicine, Abant Izzet Baysal University, Faculty of Medicine, 14280, Bolu, Turkey.
*Author to whom correspondence should be addressed.
Abstract
Aims: Gestation is very difficult in women with end stage renal disease (ESRD). In addition, human chorionic gonadotropin (HCG) may be increased in Non-pregnant women with ESRD. Therefore, elevated HCG levels in ESRD patients may cause diagnostic confusion. Here we present a case with suspicious HCG elevation who desire of pregnancy and without gonadal deficiency. We also discussed the possible reasons of this HCG elevation.
Presentation of Case: A twenty-two year old young woman with ESRD for seven years has been followed up outpatient clinics of our institution. She was receiving hemodialysis treatment for last three years after renal transplant rejection. In gynecological examination, obstetric ultrasound scan revealed no embryonic yolk sac or other radiological images of pregnancy. The case evaluated according to the algorithm of HCG elevation. Advanced clinical differential diagnosis and laboratory analyzes were performed. A diagnosis of HCG elevation due to heterophile antibodies made, which has not been previously described in the literature in ESRD patients.
Discussion and Conclusion: Heterophile antibodies should be kept in mind in evaluation of HCG increase in reproductive women with ESRD patients with transplantation history.
Keywords: Human chorionic gonadotropin, end stage renal disease, pregnancy, heterophile antibodies.