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Published:
Apr 23, 2019Keywords:
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“High‑dose hook effect” ‑ negative urine β‑HCG in molar pregnancy
Abstract
The hydatidiform mole, commonly known as molar pregnancy is characterized by the abnormal proliferation of trophoblasts. A hallmark of diagnosing hydatidiform mole is a positive β-hCG assay pregnancy test. Currently used β-hCG assays are sandwich chromatographic immunoassays and may sometimes produce false‑negative results in the presence of excessively high antigen concentrations, a phenomenon known as the “high‑dose hook effect”. We report an atypical case of molar pregnancy in a 24‑year‑old primi gravida female who presented to us in emergency department with a huge abdominopelvic mass, respiratory distress and bilateral pedal edema with a negative urine pregnancy test. Ultrasongraphy suggested it to be hydatiform mole and on further evaluation serum β-hCG was found to be raised. Repeat urine β-hCGassay showed positive result on 1:10 dilution. After resuscitation, patient was treated with suction and evacuation which demonstrated grape like vesicles with no fetal parts. Histopathology report revealed it to be complete hydatiform mole.
Key words: Hook effect; β-hCG assay; molar pregnancy.
