rifampin and Gynecomastia

A case of isoniazid induced gynecomastia is being reported in an 18-year old male, who received a re-treatment regimen for the relapse of pulmonary tuberculosis (TB). At the end of two months of the treatment, the patient developed a painless unilateral gynecomastia, which completely disappeared after a month of the cessation of isoniazid. A review of literature on isoniazid induced gynecomastia is discussed.

Topics: Adolescent; Anti-Bacterial Agents; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Gynecomastia; Humans; Isoniazid; Male; Pyrazinamide; Retreatment; Rifampin; Sputum; Streptomycin; Treatment Outcome; Tuberculosis, Pulmonary

Gynaecomastia due to anti-tubercular chemotherapy is a rare side effect. Isoniazid causing breast tissue enlargement has been very rarely reported. We report a 60-year old, male patient of Pulmonary Tuberculosis who was started on antituberculous treatment (ATT) with rifampicin (R), isoniazid (H), ethambutol (E) and pyrazinamide (Z) together for initial two months and R, H & E thereon. After five months of initiation of treatment, while receiving RHE, he developed painful bilateral gynaecomastia. Isoniazid was stopped and patient was continued on R & E till completion of the treatment up to nine months. After stopping isoniazid, his breast swelling subsided to some extent and became non-tender. Follow up, at six months, after stopping the course of treatment, patient was asymptomatic except for slight bilateral non-tender breast enlargement.

Topics: Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Gynecomastia; Humans; Isoniazid; Male; Mammography; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Pulmonary

Topics: Adult; Antitubercular Agents; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Gynecomastia; Humans; India; Isoniazid; Male; Pyrazinamide; Rifampin; Tuberculosis, Lymph Node

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.

Topics: Adolescent; Antitubercular Agents; Diagnosis, Differential; Gynecomastia; Humans; Isoniazid; Male; Pyrazinamide; Recurrence; Rifampin; Treatment Outcome; Tuberculosis, Pulmonary