Elevated Beta-Human Chorionic Gonadotropin in a Non-pregnant Female With Altered Kidney Function

Abstract

Elevated beta-human chorionic gonadotropin (beta-hCG) levels in postmenopausal women is a finding known in the literature; however, it still commonly leads to unnecessary and extensive diagnostic workup. We present the case of a 48-year-old African-American postmenopausal female with acute kidney injury on chronic kidney disease (CKD) stage 5 and an incidental finding of elevated serum beta-hCG. Abdominal and transvaginal ultrasound showed no evidence of intrauterine or ectopic pregnancy or gestational trophoblastic disease. Menopausal status was confirmed with follicle-stimulating hormone (FSH) measurement, and following the improvement of renal status, beta-hCG levels were normalized to expected values for the patient's age group. The etiology of elevated beta-hCG was suspected to be from the pituitary as previous literature has shown decreasing beta-hCG levels in postmenopausal women following the administration of gonadotropin-releasing hormone (GnRH) antagonist.

Keywords: acute kidney failure; acute kidney injury; adverse pregnancy outcome; beta-hcg; general obstetrics; gynecology and obstetrics; ob-gyn.

Figure 1. Graph depicting serum beta-hCG levels of the patient over the course of her hospital admission in mIU/mL.

Figure 2. Graph depicting the estimated glomerular filtration rate (eGFR) of the patient over the course of her hospital admission in mL/minute.