Causes gyanecomastia for MRCP
I was asked by a medical student about gyanecomastia today during my ward round.
I think it is important during your MRCP Part 1 because it is a popular question. OK, before talking about the causes, let us define what gyanecomastia is. Gyanecomastia just means male breast enlargement.
It is certainly abnormal for male to get breast enlargement, however, you may be suprised that I divide gyanecomastia into physiological and pathological gyanecomastia.
You heard me right, there are times in a male life that he can get breast enlargement abd it is totally physiological!
Man gets gyanecomastia when they are newborn, adolescents (puberty) and they are old!
Causes of pathological gyanecomastia are enormous, however there are only a few big groups,
1) Drug related
I always remember a few important ones, they are cimetidine, ranitidine ( H2 antagonists), spirolactone, digoxin and of course estrogen or drug that makes you less masculine.
2) Certain tumours
Popular ones are brochogenic carcinoma, testicular tumour and HCG producing tumours
3) Congenital
Popular syndromes are Klinefelter syndrome, Kallman syndrome
4) Systemic illness
Popular systemic illnesses are chronic liver disease and in certain chronic kidney disease.
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