Gynecomastia: a rare adverse effect of isoniazid.
We report the case of a patient who twice developed gynecomastia following tuberculosis treatment. An 18-year-old male developed painful bilateral gynecomastia after three months of treatment with the isoniazid-rifampin-pyrazinamide regimen. Partial resolution of gynecomastia was achieved at the end of treatment. The patient was retreated with the same regimen eight years later, and gynecomastia recurred after six months of treatment. Hormone levels were normal, and a mammogram revealed bilateral gynecomastia. The isoniazid was discontinued, and the gynecomastia was partially resolved by the end of treatment. Four years later, gynecomastia was not detected. We conclude that isoniazid-related gynecomastia completely resolves when the medication is discontinued. Therefore, pharmacological and surgical treatment should be avoided.
Morrone
Nelson
N
Dispensário do Ipiranga, Ação Comunitária de Saúde. nmorrone@uol.com.br
Morrone Junior
Nelson
N
Braz
Alessandra Garcia
AG
Maia
José Antonio Freire
JA
D000293:Adolescent; D000995:Antitubercular Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006177:Gynecomastia / Q000139:chemically induced*; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects*; D008297:Male; D011718:Pyrazinamide / Q000627:therapeutic use; D012008:Recurrence; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin