Gynaecomastia DDx
Overview
Gynecomastia results from increased oestrogens, decreased androgens or drugs that mimic these effects.
Causes
Increased oestrogen production
- Leydig cell tumour (oestrogen)
- Adrenal carcinoma (oestrogen)
- Bronchial carcinoma (human chorionic gonadotrophin)
- Liver disease (increased conversion of oestrogen from androgens)
- Thyrotoxicosis (increased conversion of oestrogen from androgens)
- Starvation
Decreased androgen production (hypogonadal states)
- Klinefelter syndrome
- Secondary testicular failure: orchitis, castration, trauma
- Testicular feminisation syndrome
Drugs
- Oestrogen receptor binders: oestrogen, digoxin, marijuana
- Anti-androgens: spironolactone, cimetidine
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Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC