A 14-year-old girl with premature ovarian insufficiency but with a positive pregnancy test

Robbert N. H. Touwslager, C. Michel Zwaan, Boudewijn Bakker, Eef G. W. M. Lentjes, Leendert H. J. Looijenga, Hanneke M. van Santen
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Abstract

Objectives Childhood cancer survivors are at risk for premature ovarian insufficiency, especially after treatment with alkylating agents. The objective of this report is to highlight a case in which this phenomenon caused a false-positive pregnancy test. Case presentation A workup was performed in a 14-year-old girl with a positive pregnancy test. She was diagnosed with stage IV neuroblastoma of the left adrenal gland at the age of 4 years. She received extensive treatment, including alkylating agents, and had been diagnosed with premature ovarian insufficiency. An LH/hCG suppression test was performed using high dose 17 bèta-estradiol: hCG levels normalized. Conclusions The pregnancy test was false-positive due to production of low amounts of hCG by the pituitary gland as a result of high LH concentrations following premature ovarian insufficiency. It may be helpful to perform the LH/hCG suppression test to prove pituitary origin of the hCG overproduction.
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一名患有卵巢早衰的 14 岁女孩,妊娠试验呈阳性
目的 儿童癌症幸存者有过早出现卵巢功能不全的风险,尤其是在接受烷化剂治疗后。本报告旨在重点介绍一例因这种现象导致妊娠试验假阳性的病例。病例介绍 对一名妊娠试验呈阳性的 14 岁女孩进行了检查。她在 4 岁时被诊断为左肾上腺神经母细胞瘤 IV 期。她接受了包括烷化剂在内的广泛治疗,并被诊断为卵巢早衰。使用大剂量 17bèta-estradiol 进行了 LH/hCG 抑制试验:hCG 水平恢复正常。结论 由于卵巢早衰导致 LH 浓度过高,垂体产生了少量 hCG,因此妊娠试验出现了假阳性。进行 LH/hCG 抑制试验可能有助于证明 hCG 过量产生的原因来自垂体。
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