{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:48:05Z","timestamp":1774532885766,"version":"3.50.1"},"reference-count":21,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,11,28]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>Despite the fact that a small percentage of peri en postmenopausal women have mild elevations in human chorionic gonadotrophin (hCG) concentrations (&lt;14 IU\/L) besides high levels of gonadotrophins, a considerable number of clinicians are not aware of this phenomenon. We report a case of a 53-year-old woman with an unusually high hCG concentration (&gt;40\u2009IU\/L) given her menopausal state. Although a pregnancy or a malignancy was unlikely on the basis of stable hCG levels, elevated gonadotrophins and a negative transvaginal ultrasound, her physicians were uncertain and chose an expectant approach by repeated testing. Ultimately, after consulting the laboratory, analytical interference was ruled out and pituitary origin of unusual high hCG level could be confirmed after conduction of a suppression test by oestrogen\u2013progesterone hormone replacement therapy. Until that time, the patient had undergone a vast amount of laboratory tests and gynaecology consultations, resulting in an enormous amount of confusion, anxiety and overdiagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2018-227203","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T05:16:35Z","timestamp":1546578995000},"page":"bcr-2018-227203","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Pregnancy, malignancy or mother nature? Persistence of high hCG levels in a perimenopausal woman"],"prefix":"10.1136","volume":"12","author":[{"given":"Ay\u015fe Y","family":"Demir","sequence":"first","affiliation":[{"name":"Laboratory for Clinical Chemistry and Haematology, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruben EA","family":"Musson","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem A","family":"Sch\u00f6ls","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jitze M","family":"Duk","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Meander Medical Center, Amersfoort, The 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