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.
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Conflict of interest statement
The authors declare that they have no conflict of interests.
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Fukushi, Ji., Nakashima, Y. & Iwamoto, Y. Gynecomastia associated with low-dose methotrexate therapy for rheumatoid arthritis ameliorated by folate supplement. Rheumatol Int 30, 1371–1372 (2010). https://doi.org/10.1007/s00296-009-1062-9
- Rheumatoid arthritis