Ned Tijdschr Geneeskd. 2002 Feb 2;146(5):222-4. Links
[A 35-year-old man with gynaecomastia as the first symptom of hyperthyroidism][Article in Dutch]
Mullens A, van den Bruel A, Vanderschueren D.
Katholieke Universiteit Leuven, Universitair Ziekenhuis Gasthuisberg, Kliniek en Laboratorium voor Experimentele Geneeskunde en Endocrinologie, Herestraat 49, 3000 Leuven, Belgie.
A 35-year-old man suffered painful bilateral gynaecomastia for 2 months due to serious Graves' hyperthyroidism. During treatment with propylthiouracil and levothyroxine, the plasma concentrations of thyroid hormone, sex hormones and sex hormone-binding globulin normalised and the gynaecomastia disappeared. Gynaecomastia occurs in 30 to 40% of men diagnosed with Graves' hyperthyroidism. However, gynaecomastia as a presenting symptom of this autoimmune disease is uncommon.
Ann Acad Med Singapore. 1998 Jul;27(4):594-6. Links
Hyperthyroidism with gynaecomastia as the initial complaint: a case report.Ho HK, Loh KC.
Department of General Medicine, Tan Tock Seng Hospital, Singapore.
Although gynaecomastia is a well-documented manifestation among male patients with hyperthyroidism, it is extremely rare to present as the initial or chief complaint in a subject with undiagnosed hyperthyroidism. We report a case of a 38-year-old Chinese man presenting with painful enlargement of both breasts of one month's duration. Examination revealed bilateral tender gynaecomastia. In addition, he was noted to have warm and moist peripheries, resting tachycardia and an enlarged goitre. Hyperthyroidism was confirmed biochemically. Treatment of thyrotoxicosis resulted in resolution of the gynaecomastia. This case report demonstrates that gynaecomastia may predominate over the commonly recognised, more manifest and urgent symptoms of hyperthyroidism.
: Endocr Pract. 1997 Mar-Apr;3(2):80-1. Links
Gynecomastia as the initial manifestation of hyperthyroidism.Gordon DL, Brown JL, Emanuele NV, Hall L 3rd.
Division of Endocrinology, Department of Medicine, Loyola University of Chicago, Maywood, Illinois, USA.
OBJECTIVE: To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. METHODS: We describe detailed case reports of two men with breast enlargement who were found to have hyperthyroidism, and we review the related literature. RESULTS: Two men sought medical assistance because of unilateral tender gynecomastia. In one of these patients, thyroid, gonadal, and prostate examinations showed normal findings at the time of initial assessment, and symptoms of hyperthyroidism developed later. In our other patient with gynecomastia, other symptoms of hyperthyroidism--for example, nervousness, irritability, palpitations, and fatigue--had been present for a prolonged period but had been considered "normal" by the patient. In both patients, the hyperthyroidism was treated with radioiodine. Breast pain disappeared in both patients, and breast enlargement disappeared in one patient and was decreased in the other patient after euthyroidism was achieved. Review of the literature disclosed only two similar cases. CONCLUSION: Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.
PMID: 15251481 [PubMed]
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