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

J Pediatr Endocrinol Metab. 2024 Apr 15;37(5):482-485. doi: 10.1515/jpem-2024-0019. Print 2024 May 27.

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.

Keywords: childhood cancer survivors; human chorionic gonadotropin; pituitary gland; premature ovarian insufficiency; teenage pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / pathology
  • False Positive Reactions
  • Female
  • Humans
  • Luteinizing Hormone / blood
  • Neuroblastoma / complications
  • Neuroblastoma / drug therapy
  • Neuroblastoma / pathology
  • Pregnancy
  • Pregnancy Tests
  • Primary Ovarian Insufficiency* / diagnosis
  • Primary Ovarian Insufficiency* / pathology
  • Prognosis

Substances

  • Luteinizing Hormone