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

Abstract

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.

Keywords

Rheumatoid arthritis Methotrexate Gynecomastia Folate 

References

  1. 1.
    Del Paine DW, Leek JC, Jakle C, Robbins DL (1983) Gynecomastia associated with low dose methotrexate therapy. Arthritis Rheum 26:691–692CrossRefPubMedGoogle Scholar
  2. 2.
    Thomas E, Leroux JL, Blotman F (1994) Gynecomastia in patients with rheumatoid arthritis treated with methotrexate. J Rheumatol 21:1777–1778PubMedGoogle Scholar
  3. 3.
    Thomas E, Leroux JL, Blotman F (1995) Gynecomastia after low dose methotrexate therapy for rheumatoid arthritis. J Rheumatol 22:2189PubMedGoogle Scholar
  4. 4.
    Finger DR, Klipple GL (1995) Gynecomastia following low dose methotrexate therapy for rheumatoid arthritis. J Rheumatol 22:796–797PubMedGoogle Scholar
  5. 5.
    Aguirre MA, Velez A, Romero M, Collantes E (2002) Gynecomastia and sexual impotence associated with methotrexate treatment. J Rheumatol 29:1793–1794PubMedGoogle Scholar
  6. 6.
    Pandhi D, Gupta R, Singal A (2006) Gynaecomastia with oligospermia: an unusual complication of low-dose methotrexate for pustular psoriasis. Clin Exp Dermatol 31:138–140CrossRefPubMedGoogle Scholar
  7. 7.
    Abe K, Mitsuka T, Kanamori S, Yamashita K, Yamaoka A (2007) Gynecomastia associated with low-dose methotrexate therapy for rheumatoid arthritis. Mod Rheumatol 17:511–513CrossRefPubMedGoogle Scholar
  8. 8.
    Koehler M, Heinrich U, Ludwig R, Waldherr R, Brandeis WE (1986) Effects of methotrexate on rabbit testes. Part 2: hormonal changes. Pediatr Hematol Oncol 3:335–341CrossRefPubMedGoogle Scholar
  9. 9.
    Shamberger RC, Rosenberg SA, Seipp CA, Sherins RJ (1981) Effects of high-dose methotrexate and vincristine on ovarian and testicular functions in patients undergoing postoperative adjuvant treatment of osteosarcoma. Cancer Treat Rep 65:739–746PubMedGoogle Scholar
  10. 10.
    Glass AR, Berenberg J (1979) Gynecomastia after chemotherapy for lymphoma. Arch Intern Med 139:1048–1049CrossRefPubMedGoogle Scholar

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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