Document Detail


Use of serum FSH to identify perimenopausal women with pituitary hCG.
MedLine Citation:
PMID:  18258666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Human chorionic gonadotropin (hCG) tests are performed on many female patients before performing medical procedures or administering medications that may harm a fetus. hCG of pituitary origin has been shown to increase with age. Therefore, mild increases in serum hCG in an older patient can be of pituitary origin and does not necessarily indicate pregnancy. The inability to rule out pregnancy in perimenopausal women can create clinical confusion and may delay needed therapies. Our objective was to determine the diagnostic utility of serum follicle-stimulating hormone (FSH) concentrations to rule out hCG of placental origin in perimenopausal women with a low concentration of serum hCG (5.0-14.0 IU/L). METHODS: Seven testing centers performed 39 742 physician-ordered serum quantitative hCG tests over a 15-month period. From these, 100 samples from women 41-55 years of age with serum hCG concentrations 5-14 IU/L were identified. We performed FSH testing and patient chart review for each sample. RESULTS: Twenty-three patients were found to have hCG of placental origin (pregnancy, resolving abortion, or gestational trophoblastic disease), and in those cases serum FSH was 0.4-43.8 IU/L. An FSH cutoff of 45.0 IU/L identified hCG of placental origin with 100% sensitivity and 75% specificity. FSH >45 IU/L was never observed when hCG was of placental origin (negative predictive value). CONCLUSIONS: These data indicate that quantitative serum FSH can be used to rule out pregnancy and hCG of placental origin in women 41-55 years of age with mild increase in serum hCG concentrations.
Authors:
Ann M Gronowski; Corinne R Fantz; Curtis A Parvin; Lori J Sokoll; Carmen L Wiley; Mark H Wener; David G Grenache
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-02-07
Journal Detail:
Title:  Clinical chemistry     Volume:  54     ISSN:  0009-9147     ISO Abbreviation:  Clin. Chem.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-05-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  United States    
Other Details:
Languages:  eng     Pagination:  652-6     Citation Subset:  IM    
Affiliation:
Division of Laboratory and Genomic Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. gronowski@wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / blood*
Female
Follicle Stimulating Hormone / blood*
Humans
Middle Aged
Perimenopause*
Pituitary Gland / metabolism*
Pregnancy
Pregnancy Tests / methods
Prospective Studies
Sensitivity and Specificity
Serum
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 9002-68-0/Follicle Stimulating Hormone

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