Persistently elevated serum concentrations of human chorionic gonadotropin (hCG).

OBJECTIVES: We describe a woman with constantly elevated hCG levels in serum. Since assay interference, pregnancy or cancer did not explain the elevated levels, we measured the concentrations of hCG, its ß subunit (hCGß) and its core fragment (hCGßcf) in serum and urine using specific assays, to understand the nature of the elevated hCG levels. METHODS: We used 3 assays for total hCG (these assays also recognize hCGß and to various degrees hCGßcf), 3 for intact hCG heterodimer, 3 for free hCGß and one for hCGßcf. RESULTS: With an hCG assay detecting total hCG the serum concentrations were in the range of 150-260 IU/L for the whole study period of almost 5 years, except for a peak of 1,200 IU/L, coinciding with a spontaneous abortion. Quantitation of different forms of hCG with specific immunoassays showed that the immunoreactivity in serum consisted of hCGß. Urine contained hCGß and hCGßcf. CONCLUSIONS: The laboratory findings are in keeping with familial hCG syndrome. However, so far the condition remains to be determined in any family members. Elevated hCG levels without any explanation are problematic as they cause suspicion of cancer or ectopic pregnancy and may lead to harmful therapy. Specific assays, as used here, will aid in diagnosis of such cases.

Pólipo fibroepitelial vulvar gigante / Giant vulvar fibroepithelial polyp

Los tumores benignos de origen epitelial localizados en la región vulvar tienen baja prevalencia siendo su incidencia real desconocida. El más común de ellos es el pólipo fibroepitelial (AU)

Benign epithelial tumors located in the vulvar region have a low prevalence. The most common of these is fibroepithelial polyp (AU)

Resultados perinatales en función de la dosis de betametasona administrada en gestantes / Perinatal outcomes depending on the doses of betamethasone administered in pregnant women

Objetivos: Evaluar los resultados perinatales entre diferentes dosis de corticoides antenatales. Sujetos y métodos: Estudio retrospectivo de61 gestaciones únicas con amenaza de parto prematuro, sin otra patología asociada, y con al menos una dosis estándar de betametasona por vía intramuscular (2 dosis de 12 mg/24 h). Dos grupos de estudio: grupo 1: dosis estándar, y grupo 2: una o más dosis adicionales semanales de 12 mg de betametasona. Variables maternas: semanas de gestación al inicio del tratamiento corticoideo, semanas al parto, tipo de parto, patología puerperal, entre otras; variables neonatales: sexo, índice de Apgar, peso, talla, perímetro cefálico y patología neonatal. Se realizó un estudio descriptivo y comparativo de ambos grupos. Resultados: No hubo diferencias estadísticamente significativas en los grupos. Sin embargo, se registraron más casos de displasia broncopulmonar(p = 0,09) en el grupo 1.Conclusiones: La repetición semanal de las dosis de corticoides no mejora los resultados perinatales ni asocia efectos adversos (AU)

Objectives: To evaluate perinatal outcomes between different doses of antenatal corticosteroids.Subjects and methods: Retrospective study of 61single pregnancies at risk of premature birth, withn o other associated pathology and with at least one standard dose of intramuscular betamethasone (two doses of 12 mg/24h). There were two study groups: Group 1: standard dose, and Group 2: one or more additional weekly doses of 12 mg. Maternal variables: gestational weeks at the beginning of steroid treatment, weeks at delivery, type of birth, puerperal pathology; neonatal variables: sex, Apgar score, weight, height and cephalic perimeter at birth, and neonatal pathology. We performed a descriptive and comparative study on both groups. Results: No statistically significant differences were found between the groups. However, there were more cases of bronchopulmonary dysplasia (P=.09) in group 1.Conclusions: Repeated weekly doses of corticosteroids do not improve perinatal outcomes and are not associated with adverse effects (AU)