Rheumatology International

, Volume 30, Issue 10, pp 1371–1372

Gynecomastia associated with low-dose methotrexate therapy for rheumatoid arthritis ameliorated by folate supplement

  • Jun-ichi Fukushi
  • Yasuharu Nakashima
  • Yukihide Iwamoto
Case Report


A 62-year-old male with a 10-year history of seropositive rheumatoid arthritis (RA) developed gynecomastia 8 months after beginning oral low-dose methotrexate (MTX) therapy. Two months after folate supplementation, the gynecomastia symptoms improved. Gynecomastia associated with low-dose MTX is a rare occurrence, with only nine cases previously reported in the literature. This is the first report showing folate supplementation to be effective against gynecomastia following low-dose MTX. Although it occurs infrequently, gynecomastia associated with low-dose MTX therapy should be considered in male patients with RA.


Rheumatoid arthritis Methotrexate Gynecomastia Folate 


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Jun-ichi Fukushi
    • 1
  • Yasuharu Nakashima
    • 1
  • Yukihide Iwamoto
    • 1
  1. 1.Department of Orthopaedic Surgery, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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