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TITLE:

SPIRONOLACTONE INDUCED BILATERAL GYNECOMASTIA: A STAR PATIENT CASE REPORT

AUTHORS:

Dr. Sadaf ul Hira, Dr Saba Riaz, Dr Rubab Afzal

ABSTRACT:

Abstract: Gynecomastia is benign enlargement of male breast, drug induced gynecomastia accounts for about 25 %. We are reporting a case of spironolactone induced bilateral gynecomastia. A 42-year-old male patient receiving antihypertensive drug presented with Portal vein hypertension and umbilical cord hernia and referred for surgery. 2 years back patient was a known alcoholic and admitted with chronic alcoholic liver diseases and presence of portal vein hypertension so prescribed with spironolactone with a dose of 25 mg once in a day. Investigations revealed that presence of hyperkalemia at present so; he was advised to stop spironolactone. The patient improved symptomatically but developed painful swelling of the breast after treatment which was suspected to be spironolactone induced gynecomastia. Within a month of stopping the drug, pain in the right breast subsided followed by decrease in size of swelling. Literature search indicates bilateral gynecomastia by spironolactone, but when clinician encounters unilateral presentation, they should consider the possibility of drug induced etiology. Patients should be educated about this while prescribing and eplerenone can be a safe alternative. Key Words: Drug induced bilateral gynecomastia, spironolactone, Hyperkalemia, eplerenone.

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