This 76-year-old man has a history of coronary artery disease, as evidenced by the old midline thoracotomy scar from a coronary bypass. I'm posting the image to feature his amazing gynecomastia, which developed as a side effect of his taking the prescribed diuretic spironolactone (physical exam and laboratory evaluation ruled out other potential causes).
A diagnosis of spironolactone-induced gynecomastia — an adverse drug effect seen more frequently in men taking more than 100 mg per day — was made. The mechanism is multifactorial and includes androgen-receptor blockade and increased peripheral conversion of testosterone to estradiol.
An abstract at PubMed lists other causes of drug-induced gynecomastia:
"The drugs definitely associated with the onset of gynecomastia are spironolactone, cimetidine, ketoconazole, hGH, estrogens, hCG, anti-androgens, GnRH analogs and 5-α reductase inhibitors. Medications probably associated with gynecomastia include risperidone, verapamil, nifedipine, omeprazole, alkylating agents, HIV medications (efavirenz), anabolic steroids, alcohol and opioids."
Trivial/juvenile comments will be blocked.
No comments:
Post a Comment