H Levavi1, A Neri, J Bar, D Regev, J Nordenberg, J Ovadia. 1. Department of Obstetrics and Gynecology, Beilinson Medical Center, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Abstract
BACKGROUND: In some cases of gestational trophoblastic disease, a large amount of serum beta-hCG may lead to the high-dose "hook effect" with falsely low serum levels, creating misdiagnosis or delay in diagnosis and therapeutic hazards to the patient. CASES: In two cases of the hook effect in complete hydatidiform mole, ultrasonographic scan showed intrauterine echogenic material, whereas diluted serum specimens gave very high levels of beta-hCG (1,600,000 and 2,225,000 mIU/mL). CONCLUSION: The possibility of a method-dependent hook effect must be considered. Early recognition of falsely low values of beta-hCG can allow correction to the true values by various methods, such as serum dilution before the radioimmunometric method.
BACKGROUND: In some cases of gestational trophoblastic disease, a large amount of serum beta-hCG may lead to the high-dose "hook effect" with falsely low serum levels, creating misdiagnosis or delay in diagnosis and therapeutic hazards to the patient. CASES: In two cases of the hook effect in complete hydatidiform mole, ultrasonographic scan showed intrauterine echogenic material, whereas diluted serum specimens gave very high levels of beta-hCG (1,600,000 and 2,225,000 mIU/mL). CONCLUSION: The possibility of a method-dependent hook effect must be considered. Early recognition of falsely low values of beta-hCG can allow correction to the true values by various methods, such as serum dilution before the radioimmunometric method.
Authors: Sherif Abd-Elkarim Mohammed Shazly; Mohammed Khairy Ali; Ahmed Yahia Abdel Badee; Abu-Bakr Abbas Alsokkary; Mostafa Mohammed Khodary; Nehal Abd-Elkarim Mostafa Journal: J Med Case Rep Date: 2012-04-03