Gynecomastia can be caused by elevated estrogen levels, decreased testosterone levels, or both. In pubertal males, adult estrogen levels are reached before adult testosterone levels. The effects of estrogen further causes increases sex-hormone binding globulins which further lowers testosterone, leading to gynecomastia (FA 2019-332; FA2020-337). Another cause of gynecomastia is hypogonadism (FA 2019-635; FA2020-649), which is what this patient seems to be experiencing .
Differentials: Kallman?, Prader Willi?,idiopathic
I personally put low pitched voice, thinking his low testosterone would cause delay in deepening of his voice but I guess this varies and gynecomastia is a "better" choice in the eyes of NBME.
submitted by โjbrito718(48)
Gynecomastia can be caused by elevated estrogen levels, decreased testosterone levels, or both. In pubertal males, adult estrogen levels are reached before adult testosterone levels. The effects of estrogen further causes increases sex-hormone binding globulins which further lowers testosterone, leading to gynecomastia (FA 2019-332; FA2020-337). Another cause of gynecomastia is hypogonadism (FA 2019-635; FA2020-649), which is what this patient seems to be experiencing .
Differentials: Kallman?, Prader Willi?,idiopathic I personally put low pitched voice, thinking his low testosterone would cause delay in deepening of his voice but I guess this varies and gynecomastia is a "better" choice in the eyes of NBME.