Dahlan Randah Abdullah, Sait Maram Khalid, Monjed Alaa Khalil
Department of Internal Medicine, King Abdullah Medical City, Mecca, Makkah Province, Saudi Arabia.
Department of Internal Medicine, King's College Hospital London, Jeddah, Makkah Province, Saudi Arabia.
Case Rep Nephrol. 2025 Apr 6;2025:6653329. doi: 10.1155/crin/6653329. eCollection 2025.
Gynecomastia is a benign proliferation of the glandular tissue of the male breast. It is a common physiological condition during infancy and puberty and typically resolves spontaneously in most cases. However, adult-onset gynecomastia requires proper evaluation to identify the underlying cause. Several medications are associated with gynecomastia in adults, with some having a clear pathophysiologic mechanism while others do not. We report a 78-year-old male with chronic kidney disease (CKD) who developed painful gynecomastia following the administration of darbepoetin. The gynecomastia resolved upon cessation of darbepoetin but recurred upon its reintroduction. Extensive evaluation did not identify any other underlying cause. To our knowledge, this is the first case describing an association between darbepoetin and gynecomastia. In addition to presenting the case, we briefly discuss the hormonal changes in CKD patients and the potential effects of synthetic erythropoiesis-stimulating agents (ESAs) on hormone regulation.
男性乳房肥大是男性乳腺腺体组织的良性增生。它是婴儿期和青春期常见的生理状况，在大多数情况下通常会自行消退。然而，成人期男性乳房肥大需要进行适当评估以确定潜在病因。几种药物与成人男性乳房肥大有关，其中一些有明确的病理生理机制，而另一些则没有。我们报告一例78岁患有慢性肾脏病（CKD）的男性，在使用达比泊汀后出现疼痛性男性乳房肥大。停用达比泊汀后男性乳房肥大消退，但重新使用时复发。广泛评估未发现任何其他潜在病因。据我们所知，这是第一例描述达比泊汀与男性乳房肥大之间关联的病例。除了介绍该病例外，我们还简要讨论了CKD患者的激素变化以及合成促红细胞生成剂（ESA）对激素调节的潜在影响。
