Table 1.
Case reports of isoniazid-induced gynecomastia in the English literature
| Author (yr of publication) | Age (in yr) | Diagnosis | Treatment | Onset of gynaecomastia after ATT | Clinical features | Outcome |
|---|---|---|---|---|---|---|
| 1. Khanna et al. (2003) [7] | 25 | Right TB pleural effusion | 2HRZE/2HR, H 300 mg, R 450 mg, Z 1500 mg, E 800 mg | 4 m | Right painful breast 5x4cm Left painless nipple swelling | Bilateral breast swellings persisted for 3 m after ATT stopped, but decreased slightly and non-tender; subsided at 1 yr |
| 2. Dixit et al. (2008) [8] | 42 | TB cervical lymph node | 2H3R3Z3/2H3R3/2REC, H 600 mg, R 450 mg, Z 1500 mg | 4 m | Left painful breast 6x8cm | H stopped at 4th m and breast swelling subsided after 6 months |
| 3. Morrone et al. (2008) [9] | 18 | Cavitatory pulmonary TB (2 episodes) |
1st episode: 2HRZ/4HR 2nd episode: 2HRZ/4HR/6R, H 400 mg, R 600 mg, Z 2000 mg |
1st episode: 3 m; 2nd episode: 6 m |
1st episode: mildly tender small breast swellings 2nd episode: Right tender breast swelling 5 cm |
Gynaecomastia remained 2 months after H stopped and resolved 2 m after 1 yr of ATT |
| 4. Garg et al. (2009) [10] | 60 | Pulmonary TB | 2HRZE/3HRE/4RE, H 300 mg, R 450 mg, Z 1000 mg, E 800 mg | 5 m | Bilateral tender breast swellings 5x6cm | Breast swellings became non-tender after H stopped and resolved 6 m after 9 m of ATT |
| 5. Mansoor et al. (2009) [11] | 50 | TB epididymo-orchitis | 2HRZE/4HR, H 300 mg, R 450 mg, Z 1500 mg, E 800 mg | 4 m | Bilateral painful breast swellings | After H stopped, breast swellings resolved at 6 m of ATT |
| 6. Lee et al. (2009) [12] | 72 | Pulmonary TB | 2HRZ3E3/2 HRE3/5 RE3, H 300 mg, R 600 mg, Z 1000 mg, E 400 mg | 4 m | Bilateral painful breast swellings 4 cm | Breast swellings resolved 1.5 m after H stopped |
| 7. Agrawal et al. (2011) [13] | 28 | Pulmonary TB | 2HRZE/4HR, H: 300 mg, R: 450 mg, Z: 1500 mg, E: 800 mg | 3 m | Bilateral tender breast swellings 3x4cm | Breast pain and swellings subsided 2 m after H stopped |
| 8. Goud et al.(2012) [14] | 45 | Pulmonary TB | 2HRZE/2HR/5RE, H 300 mg, R 450 mg, Z 1500 mg, E 800 mg | 4 m | Left painful breast swelling 5x4cm | Breast swelling resolved 1 m after H stopped |
| 9. Khan (2012) [15] | 45 | Bilateral TB cervical lymph node | 2H3R3Z3/1H3R3/3R3E3, H 600 mg, R 600 mg, Z 1500 mg | 3 m | Left painful breast swelling 4 cm | Pain subsided 1 m after H stopped and breast swelling decreased by 25% at 3 m after H stopped |
| 10. Neki (2016) [16] | 24 | Pulmonary TB | 2HRZE/2.5HRE/4.5RE, H: 300 mg, R: 450 mg, Z: 1500 mg, E: 800 mg | 4.5 m | Bilateral tender breast swellings 4x3cm | Breast pain and swelling subsided 1 m after H stopped |
ATT anti-tuberculosis therapy
Drugs, H Isoniazid, R Rifampicin, Z Pyrazinamide, E Ethambutol, C Cirpofloxacin
Duration: Shown by the number (in months) in front of the drugs, separated by the slash “/” to indicate another phase of treatment
Frequency: Shown by the subscript attached to the individual drug (i.e. subscript “3” indicates thrice weekly administration and no subscript indicates daily administration)