{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T05:48:06Z","timestamp":1741153686183,"version":"3.38.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Elevated human chorionic gonadotropin (hCG) of unknown etiology is often a diagnostic dilemma. Determination of its source is vital in order to provide proper medical treatment and prevent possible unneeded therapeutic interventions. The differential diagnosis for elevated hCG is broad and includes pregnancy, chronic kidney disease, heterophile antibody, macro-hCG, exogenous hCG administration, pituitary secretion, tumor-associated secretion, etc. One entity that is emerging in the published literature as a cause of elevated hCG is familial hCG syndrome. This syndrome is characterized by persistently elevated concentrations from a yet to be determined source in individuals of the same family. In this special report, we review a recently published case of elevated hCG in a 56-year-old male proposed to be due to familial hCG syndrome. We discuss why we feel the presented case is not consistent with familial hCG syndrome and explore other possible explanations for the patient\u2019s elevated hCG concentrations.<\/jats:p>","DOI":"10.1093\/jalm\/jfae143","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T16:12:43Z","timestamp":1734451963000},"page":"493-496","source":"Crossref","is-referenced-by-count":0,"title":["A Second Opinion: Expert Commentary on \u201cPersistent Mild Increase of Human Chorionic Gonadotropin in a Male Patient with Testicular Pain\u201d"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-361X","authenticated-orcid":false,"given":"Callie","family":"Torres","sequence":"first","affiliation":[{"name":"Department of Pathology & Immunology, Washington University in St. Louis School of Medicine , St. Louis, MO ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Department of Pathology & Immunology, Washington University in St. Louis School of Medicine , St. Louis, MO ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann M","family":"Gronowski","sequence":"additional","affiliation":[{"name":"Department of Pathology & Immunology, Washington University in St. Louis School of Medicine , St. Louis, MO ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"2025030423061410500_jfae143-B1","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1093\/jalm\/jfae042","article-title":"Persistent mild increase of human chorionic gonadotropin in a male patient with testicular pain","volume":"9","author":"Castillo P\u00e9rez","year":"2024","journal-title":"J Appl Lab Med"},{"key":"2025030423061410500_jfae143-B2","doi-asserted-by":"crossref","first-page":"458","DOI":"10.12688\/f1000research.53636.1","article-title":"Case report: the first familial hCG syndrome in a Chinese family","volume":"10","author":"Hung","year":"2021","journal-title":"F1000Res"},{"key":"2025030423061410500_jfae143-B3","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1515\/cclm-2021-0533","article-title":"False-positive pregnancy test: beware of familial hCG syndrome","volume":"59","author":"Deltombe","year":"2021","journal-title":"Clin Chem Lab Med"},{"key":"2025030423061410500_jfae143-B4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.gynor.2014.05.005","article-title":"Familial HCG syndrome: a diagnostic challenge","volume":"10","author":"Tan","year":"2014","journal-title":"Gynecol Oncol Rep"},{"key":"2025030423061410500_jfae143-B5","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jri.2011.11.001","article-title":"Familial HCG syndrome","volume":"93","author":"Cole","year":"2012","journal-title":"J Reprod Immunol"},{"key":"2025030423061410500_jfae143-B6","first-page":"435","article-title":"Familial hCG syndrome: production of variable, degraded or mutant forms of hCG","volume":"59","author":"Cole","year":"2014","journal-title":"J Reprod Med"},{"key":"2025030423061410500_jfae143-B7","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1373\/clinchem.2007.100305","article-title":"Use of serum FSH to identify perimenopausal women with pituitary hCG","volume":"54","author":"Gronowski","year":"2008","journal-title":"Clin Chem"},{"key":"2025030423061410500_jfae143-B8","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.clinbiochem.2016.11.017","article-title":"Establishing reference intervals for hCG in postmenopausal women","volume":"4","author":"Patel","year":"2017","journal-title":"Clin Biochem"},{"key":"2025030423061410500_jfae143-B9","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1373\/clinchem.2005.053595","article-title":"Diagnostic considerations in the measurement of human chorionic gonadotropin in aging women","volume":"51","author":"Snyder","year":"2005","journal-title":"Clin Chem"},{"key":"2025030423061410500_jfae143-B10","first-page":"38","article-title":"Pituitary as a source of HCG: residual levels after bilateral testicular tumor removal","volume":"45","author":"Santen","year":"2019","journal-title":"J Investig Med"},{"key":"2025030423061410500_jfae143-B11","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1590\/s1677-5538.ibju.2017.0654","article-title":"Supposed pituitary-production of human chorionic gonadotropin induced by androgen deprivation therapy","volume":"45","author":"Yoshimura","year":"2019","journal-title":"Int Braz J Urol"},{"key":"2025030423061410500_jfae143-B12","first-page":"424","article-title":"Elevated human chorionic gonadotropin levels in patients with chronic kidney disease","volume":"23","author":"Soni","year":"2013","journal-title":"Case Series and Review of Literature. 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