From the Guidelines
Elevated beta human chorionic gonadotropin (beta hCG) levels are most commonly caused by pregnancy, as this hormone is produced by the placenta after implantation, but can also be caused by other conditions such as gestational trophoblastic diseases, certain types of cancer, and pituitary dysfunction, as noted in a recent study 1. The causes of elevated beta hCG levels can be categorized into several groups, including:
- Pregnancy-related conditions, such as multiple pregnancies, molar pregnancies, and choriocarcinoma, which can cause dramatically elevated hCG levels due to abnormal growth of placental tissue 1.
- Certain types of cancer, particularly testicular and ovarian germ cell tumors, which can produce hCG as a tumor marker 1.
- Pituitary dysfunction, which can cause mildly elevated hCG levels, especially in postmenopausal women 1.
- Laboratory errors or cross-reactivity with other hormones in some assays, which can occasionally lead to falsely elevated results 1.
- Other conditions, such as Down syndrome and other chromosomal abnormalities in the fetus, which can be associated with higher maternal serum hCG levels [@Example@]. It is essential to consider the clinical context and perform follow-up testing to determine the underlying cause of elevated beta hCG levels, as the timing of pregnancy and the presence of other symptoms can affect the interpretation of hCG levels 1.
From the Research
Causes of Elevated Beta Human Chorionic Gonadotropin (beta hCG)
- Pregnancy is a primary cause of elevated beta hCG levels 2, 3, 4, 5
- Gestational trophoblastic disease, including gestational trophoblastic neoplasia (GTN) and choriocarcinoma, can also lead to elevated beta hCG levels 2, 4, 5
- Ovarian and peripheral germ cell tumors are associated with elevated beta hCG levels 2, 4
- Nongynecologic cancers, such as anal squamous cell carcinoma, can cause elevated beta hCG levels due to ectopic excretion by the tumor 6
- Hyperreactio luteinalis, a condition characterized by bilateral complex adnexal masses, can also lead to markedly elevated beta hCG levels in normal singleton pregnancies 3
- False-positive beta hCG results can occur, and it is essential to exclude this possibility through further testing 4
- Menopause can also be a cause of elevated beta hCG levels 4
- In some cases, no underlying cause for persistently elevated beta hCG levels can be found, and long-term follow-up is necessary to monitor for potential malignancy 4, 5