Bjork J T, Varma R R, Borkowf H I
Gastroenterology. 1977 Jun;72(6):1308-11.
Clomiphene citrate therapy was initiated in a male with Laennec's cirrhosis complicated by gynecomastia, testicular atrophy, impotence, and loss of libido. The patient had abstained from alcohol and had stable hepatic function tests for 1 year before starting therapy. Luteinizing hormone and endogenous testosterone levels were maximally elevated with low dose therapy (50 mg per day). Follicle-stimulating hormone was maximally elevated with a dose of 100 mg per day and the elevation of total estrogen levels was not affected by increasing the dose. During treatment increase in testicular size was noted with resolution of impotence and improvement of libido which continued for 6 months after cessation of therapy. Gynecomastia remained unchanged despite the increased serum testosterone. Serum prolactin was normal before and after the clomiphene citrate. Semen initially unobtainable was analyzed after completion of therapy. The patient relapsed 8 months after the course of clomiphene citrate therapy.
对一名患有Laennec肝硬化并伴有男性乳房发育、睾丸萎缩、阳痿和性欲减退的男性患者开始使用枸橼酸氯米芬治疗。该患者已戒酒，在开始治疗前肝功能检查稳定了1年。低剂量治疗（每天50毫克）时促黄体生成素和内源性睾酮水平最大程度升高。促卵泡生成素在每天100毫克的剂量时最大程度升高，总雌激素水平的升高不受剂量增加的影响。治疗期间注意到睾丸大小增加，阳痿症状缓解，性欲改善，停药后这种改善持续了6个月。尽管血清睾酮增加，但男性乳房发育仍无变化。枸橼酸氯米芬治疗前后血清催乳素均正常。治疗结束后对最初无法获取的精液进行了分析。枸橼酸氯米芬疗程结束8个月后患者复发。
