Oteri Alessandro, Catania Maria Antonietta, Travaglini Rita, Russo Alessandra, Giustini Saffi E, Caputi Achille P, Polimeni Giovanni
Department of Clinical and Experimental Medicine and Pharmacology, Section of Pharmacology, University of Messina, Messina, Italy.
Pharmacotherapy. 2008 Apr;28(4):549-51. doi: 10.1592/phco.28.4.549.
Gynecomastia is characterized by benign progressive enlargement of the male breast. A pharmacologic origin is identified in 10-20% of cases. Several case reports have associated this condition to the use of statins. However, to our knowledge, no case of rosuvastatin-induced gynecomastia has been reported in the literature. We describe a 57-year-old man who developed bilateral gynecomastia after 2 months of rosuvastatin therapy. After switching to a different statin, atorvastatin, his symptoms resolved within 1 month. Use of the Naranjo adverse drug reaction probability scale indicated a possible relationship between the patient's development of gynecomastia and rosuvastatin therapy. The relatively strong effect of rosuvastatin on inhibiting steroidogenesis might have explained why our patient's gynecomastia occurred only with this agent. Clinicians should be aware of the possibility of adverse endocrine reactions when statins are prescribed, including newer agents such as rosuvastatin.
男性乳房肥大症的特征是男性乳房出现良性进行性增大。10%至20%的病例可确定有药物性病因。有几例病例报告将这种情况与他汀类药物的使用联系起来。然而,据我们所知,文献中尚未报道过瑞舒伐他汀引起男性乳房肥大症的病例。我们描述了一名57岁男性,在接受瑞舒伐他汀治疗2个月后出现双侧男性乳房肥大症。换用另一种他汀类药物阿托伐他汀后,他的症状在1个月内得到缓解。使用纳伦霍药物不良反应概率量表表明,患者男性乳房肥大症的发生与瑞舒伐他汀治疗之间可能存在关联。瑞舒伐他汀对抑制类固醇生成的相对较强作用可能解释了为什么我们的患者仅使用这种药物时才出现男性乳房肥大症。临床医生在开具他汀类药物(包括瑞舒伐他汀等新型药物)时应意识到发生不良内分泌反应的可能性。