Severe gynaecomastia associated with spironolactone treatment in a patient with decompensated alcoholic liver cirrhosis - case report

• Autorzy: Schab K. , Prystupa A. , Mulawka D. , Mulawka P.
• Języki publikacji: EN

Abstrakty

EN

Gynaecomastia is uni- or bilateral breast enlargement in males associated with benign hyperplasia of the glandular, fibrous and adipose tissue resulting from oestrogen-androgen imbalance. Asymptomatic gynaecomastia is a common finding in healthy male adults and does not have to be treated, while symptomatic gynaecomastia might be the symptoma of many pathological conditions and requires meticulous diagnosis and therapeutic management. The commonest causes of gynaecomastia in the Polish population include liver cirrhosis and drugs used to treat its complications. The current study presents the case of severe painless gynaecomastia in a patient with decompensated alcoholic liver cirrhosis, treated with spironolactone because of ascites. Breast enlargement assessed a IIb according to the Simon’s Scale or III according to the Cordova-Moschella classification, developed slowly over the two-year period of low-dose spironolactone therapy The course and dynamics of disease are described and the main mechanisms leading to its development discussed. The importance of effective treatment of patients with severe gynecomastia is emphasized as the disease may result in significant psychosocial problems.

Słowa kluczowe

EN

gynaecomastia; spironolactone; treatment; patient; alcoholic disease; liver cirrhosis

• Wydawca: -
• Czasopismo: Journal of Pre-Clinical and Clinical Research
• Rocznik: 2015
• Tom: 09
• Numer: 1
• Opis fizyczny: p.92-95,fig.,ref.

Twórcy

autor

Schab K.

• 1st Military Teaching Hospital and Polyclinic, Lublin, Poland

autor

Prystupa A.

• Department of Internal Medicine, Medical University, Staszica 16, 20-081 Lublin, Poland

autor

Mulawka D.

• Cardinal Stefan Wyszynski District Specialist Hospital, Lublin, Poland

autor

Mulawka P.

• Cardinal Stefan Wyszynski District Specialist Hospital, Lublin, Poland

Bibliografia

• 1. Johnson RE, Murad MH. Gynecomastia: Pathophysiology, Evaluation, and ManagementMayo Clin Proc. 2009; 84(11): 1010–1015.
• 2. Niewoehner CB, Nuttal FQ. Gynecomastia in a hospitalized male population. Am J Med. 1984; 77(4): 633–638.
• 3. Trivedi M. Androgen replacement in early alcoholic cirrhosis? Postgrad Med. 2005; 117:32.
• 4. Braunstein GD. Gynecomastia. N Engl J Med. 1993; 328: 490–495.
• 5. Simon BE, Hoffman S, Kahn S. Classification and surgical correction of gynaecomastia. Plast Reconstr Surg. 1973; 51: 48.
• 6. Alfredo Carlos Simões Dornellas de Barros, Marcelo de Castro Moura Sampaio Gynecomastia: physiopathology, evaluation and treatment. Sao Paulo Med J. 2012; 130(3): 187–197.
• 7. Baker HWG, Burger HG, deKretser DM, et al. A study of the endocrine manifestations of liver cirrhosis. Q J Med. 1976; 45(new series):145–178.
• 8. Bannister P, Lowosky MS. Ethanol and hypogonadism. Alcohol and Alcoholism 1987; 22(3): 213–217.
• 9. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure.Randomized Aldactone Evaluation Study Investigators. N Engl J Med.1999; 341(10): 709–717.
• 10. Satoh T, Fujita KI, Munakata H, et al. Studies on the interactions between drugs and estrogen: analytical method for prediction systemof gynecomastia induced by drugs on the inhibitory metabolism ofestradiol using Escherichia coli coexpressing human CYP3A4 withhuman NADPH-cytochrome P450 reductase. Anal Biochem. 2000;286(2): 179–186.
• 11. Carvajal A, Macias D, Gutie´rrez A, et al. Gynaecomastia associated with proton pump inhibitors: a case series from the SpanishPharmacovigilance System. Drug Saf. 2007; 30(6): 527–531.
• 12. Santucci L, Farroni F, Fiorucci S, et al. Gynecomastia during omeprazole therapy. N Engl J Med. 1991; 324(9): 635.
• 13. Bellati G, Ideo G. Gynecomastia after spironolactone and potassium cancreonate. Lancet 1986; I: 626.
• 14. Overdiek JWPM, Markus FWHM. Spironolactone metabolism and gynecomastia. Lancet 1986; 10:1103.
• 15. Dimitriadis G, Papadopoulos V, Mimidis K. Eplerenone reverses spironolactone-induced painful gynaecomastia in cirrhotics. HepatolInt. 2011; 5: 738–739.
• 16. Colombo-Benkmann M, Buse B. Surgical therapy of gynaecomastia and its results. Langenbecks Arch Chir Suppl Kongress. 1998; 11: 1282–1284.
• 17. Kasielska A, Antoszewski B. Effect of operative treatment on psychosicial problems of men with gynecomastia. Polski Przegląd Chirurgiczny 2011;83(11): 614–621.
• 18. Loriaux DL, Menard R, Taylor A, Pita JC, Santen R. Spironolactone and endocrine dysfunction. Ann Intern Med. 1976; 85: 630–636.
• 19. Coen P, Kulin H, Ballantine T, et al. An aromatase producing sex-cord tumour resulting in prepubertal gynaecomastia. N Engl J Med. 1991; 324(5): 317–322.
• 20. Cilotti A, Campassi C, Bagnolesi P, Moretti M, Caramella D, Bartolozzi C. Gynecomastia: diagnostic value of high frequencies ultrasound (10–13 MHz). Breast Dis.1996; 9: 61–69.

Identyfikatory

DOI

10.5604/18982395.1157586