Another Case of Breast Hypertrophy in a Patient Treated with Indinavir

Lui, Anita; Karter, Dennis; Turett, Glenn S.

doi:10.1086/517654

Cited by 34 publications

(8 citation statements)

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“…HAART has been associated with both lipomastia and gynecomastia in multiple case reports [3][4][5][6][7][8][9][10][11][12]. Lipomastia in HIV-infected patients is considered to be secondary to the metabolic derangements of the fat maldistribution syndrome [13].…”

Section: Discussionmentioning

confidence: 99%

“…It remained a rarely diagnosed condition until the widespread use of HAART began nearly a decade later. Since 1997, there have been multiple reports of breast enlargement in HIV-infected men, most often in association with protease inhibitorbased regimens [3][4][5][6][7][8][9][10][11][12]. However, a clear distinction between true gynecomastia and lipomastia was not made for many of these reported cases, leaving uncertain the true frequency and pathogenesis of each condition.…”

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confidence: 99%

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Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

et al. 2002

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Breast enlargement, a condition that was rarely reported in the era before highly active antiretroviral therapy, is emerging as a problem in the treatment of male human immunodeficiency virus (HIV)-infected patients. Evaluation of this condition must distinguish between gynecomastia (proliferation of ducts and periductal stroma), lipomastia (adipose-tissue deposition), and malignancy. We describe 13 HIV-infected men, all of whom had exposure to antiretroviral therapy, who presented with breast enlargement. Nine of these patients had gynecomastia, only 1 had lipomastia, and 3 had lymphoma (2 had non-Hodgkin lymphoma and 1 had Hodgkin disease). Gynecomastia was unilateral in all but a single case. In addition, all but 1 of our patients with gynecomastia had prolonged exposure to protease inhibitors. Six patients had potential causes of gynecomastia other than antiretroviral therapy, including liver disease (in 2 patients), mild hypogonadism (in 1), long-term marijuana use (in 2), and use of medications that have known associations with gynecomastia (in 3). Although most causes of breast enlargement in HIV-infected men are likely to be benign, malignancies other than carcinoma are of concern.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

et al. 2002

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The causes of these disorders are not well understood and proper therapy is not available. At present it is not known whether discontinuation of antiretroviral treatment will reverse the metabolic adverse events.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Breast enlargement caused by fat accumulation is one of the alterations most frequently observed in women receiving highly active antiretroviral therapy (HAART). [10][11][12][13][14] Less frequently, breast hypertrophy caused by true gynecomastia (benign enlargement of breast tissue) or "lipomastia" has been reported in men receiving HAART. [15][16][17][18][19][20] Treatment strategies developed to manage these alterations include modifications of antiretroviral regimens, [21][22][23][24][25][26][27] lifestyle changes, 28,29 drug and hormonal therapies, [30][31][32][33][34][35][36] and surgery.…”

Section: Introductionmentioning

confidence: 99%

Maintenance of Breast Size Reduction After Mastoplasty and Switch to a Protease Inhibitor-Sparing Regimen in an HIV-Positive Woman with Highly Active Antiretroviral Therapy-Associated Massive Breast Enlargement

Gervasoni

Ridolfo²,

Rovati³

et al. 2002

AIDS Patient Care and STDs

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Fat distribution disorders are among the most frequent side effects of antiretroviral treatment. The pathophysiologic mechanism(s) for these events remains unclear, and a casual link to a specific drug or class of drugs is uncertain. The physical changes associated with the lipodystrophy syndrome can be divided into three major types: lipoatrophy or fat wasting; lipohypertrophy or fat accumulation; and mixed forms with atrophy and hypertrophy coexisting in different body regions. Fat accumulation can occur in one or more of several areas including dorsal-cervical and abdominal regions and breasts. Withdrawal of antiretroviral therapy does not seem to influence the stabilized lesions significantly, and no one of the therapeutic strategies adopted so far was capable to achieve substantial improvements. Here we describe the successful and lasting treatment of a massive and movement/posture-hampering breast hypertrophy with reductive mastoplasty.

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“…1 Of the large spectrum of reported alterations, three clinical pictures have most frequently been described: a condition mainly characterized by subcutaneous fat depletion, accompanied or not by increased abdominal adiposity [2][3][4][5] ; localized abnormal fat accumulation [6][7][8][9][10][11] ; and combined alterations in which fat accumulation and loss are both present in different body regions. [12][13] Metabolic abnormalities, including hyperlipidemia and insulin resistance, are also frequently observed in patients affected with fat tissue alterations, particularly in those presenting protease inhibitor-associated lipodystrophy.…”

Section: Introductionmentioning

confidence: 99%

Body Habitus Alterations in HIV-Infected Women Treated with Combined Antiretroviral Therapy

Ridolfo

Gervasoni²,

Bini³

et al. 2000

AIDS Patient Care and STDs

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Fat distribution alterations are among the most frequent and unexpected side effects of combined antiretroviral therapy. They may occur in patients receiving protease inhibitor-containing regimens and those treated with combinations of only nucleoside reverse transcriptase inhibitors. The broad spectrum of body fat alterations, which are variably associated with metabolic abnormalities, raises the question as to whether they represent different components of the same syndrome or are manifestations of different pathogenetic mechanisms. Recent clinical evidence is consistent with a higher risk of developing body fat alterations in females. We here report three different aspects of body habitus changes in women treated with various antiretroviral regimens and describe their short-term follow-up. We also discuss the possible pathogenetic implications and the role of different drug classes according to present knowledge.

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Another Case of Breast Hypertrophy in a Patient Treated with Indinavir

Cited by 34 publications

References 0 publications

Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

Maintenance of Breast Size Reduction After Mastoplasty and Switch to a Protease Inhibitor-Sparing Regimen in an HIV-Positive Woman with Highly Active Antiretroviral Therapy-Associated Massive Breast Enlargement

Body Habitus Alterations in HIV-Infected Women Treated with Combined Antiretroviral Therapy

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