Objective To analyze the causes of misdiagnosis and preventive measures of elevated human chorionic gonadotropin(hCG)with persistently low levels.Methods The clinical data of 2 patients with elevated hCG with persistent low levels initially misdiagnosed and admitted from May 2022 to December 2023 were retrospectively analyzed.Results One patient presented with menopausal and increased hCG level for 4 months,but no decrease in blood hCG level after chemothera-py.One patient presented with abnormal uterine bleeding for 4 d and at 50 d after induced abortion.Ultrasonography showed no abnormality in 1 patient,and abnormal uterine echo and low resistance of myometrium echo in 1 patient.One patient was initially diagnosed with gestational trophoblastic disease(GTD)and received 2 cycles of chemotherapy with Methotrexate com-bined with Formyltetrahydrofolate regimen.One patient was initially diagnosed with uterine arteriovenous fistula+gestational residue,and was treated with uterine arteriography combined with hysteroscopic diagnostic curettage.One patient did not have a decrease in hCG level after chemotherapy.One patient had negative angiography results,and no pregnancy was found in his-topathological examination of intrauterine matter.It was confirmed that the primary hCG level with persistently low level was elevated in two patients,who,however,did not receive specific treatment.Conclusion The elevated serum hCG with per-sistently low level is rare and atypical in clinical setting.If hCG examination in hematuria,sex hormone examination or careful distinguishment of ultrasound image features are not performed,it is more likely to be confused with other diseases such as trophoblastic diseases.The doctor should enhance the vigilance of this disease and strengthen the understanding of this dis-ease.For those with a history of menopausal and abnormal uterine bleeding,hematuria hCG,ultrasound and magnetic reso-nance examination should be performed as soon as possible,and the medical history should be carefully inquired.If necessa-ry,a full set of sex hormones and ovarian function test should be included to confirm the diagnosis.
维普
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