Ginecomastia: um efeito colateral raro da isoniazida

Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis.

show abstract

“…We attribute this to a rare side effect of hydrazide, which has been reported by other authors. ( 9 ) …”

Section: Case Reportmentioning

confidence: 99%

“…Atribuímos esse fato a um raro efeito colateral da hidrazida, já observado por outros autores. ( 9 ) …”

Section: Relato De Casounclassified

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

et al. 2013

View full text Add to dashboard Cite

show abstract

“…and resolution following its withdrawal strongly supports its causal relationship rather. [12] The exact mechanism of isoniazid causing gynecomastia remains unknown; plausible proposed mechanisms are altered androgen–estrogen due to disturbance in pyridoxine metabolism as well as refeeding syndrome during recovery from chronic illness, which needs further clarification. [11]…”

mentioning

confidence: 99%