Gynecomastia laboratory findings: Difference between revisions

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__NOTOC__
__NOTOC__
{{Gynecomastia}}
{{Gynecomastia}}
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{HS}}


==Overview==
==Overview==
*An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
Gynecomastia is diagnosed clinically after a thorough history and physical examination. A recent onset of gynecomastia with tenderness on the examination require the following laboratory studies: Serum concentrations of [[Human chorionic gonadotropin|human chorionic gonadotropin (hCG)]], [[LH]], [[testosterone]], and [[estradiol]]. The hormonal levels may vary depending on the underlying cause.
*Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
*[Test] is usually normal among patients with [disease name].
*Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
*There are no diagnostic laboratory findings associated with [disease name].


==Laboratory Findings==
==Laboratory Findings==
 
* [[Asymptomatic]] gynecomastia which is discovered on physical examination has a very low diagnostic yield and usually normal blood hormone levels.
*There are no diagnostic laboratory findings associated with [disease name].
* Gynecomastia which is [[Tenderness (medicine)|tender]] and of recent onset should have, following lab work up:<ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754  }} </ref><ref name="pmid17090633">{{cite journal| author=Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H| title=Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. | journal=J Clin Endocrinol Metab | year= 2007 | volume= 92 | issue= 2 | pages= 405-13 | pmid=17090633 | doi=10.1210/jc.2006-1864 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17090633  }} </ref><ref name="pmid11158037">{{cite journal| author=Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging| title=Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 2 | pages= 724-31 | pmid=11158037 | doi=10.1210/jcem.86.2.7219 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11158037  }} </ref><ref name="pmid3532913">{{cite journal| author=Ismail AA, Astley P, Burr WA, Cawood M, Short F, Wakelin K et al.| title=The role of testosterone measurement in the investigation of androgen disorders. | journal=Ann Clin Biochem | year= 1986 | volume= 23 ( Pt 2) | issue=  | pages= 113-34 | pmid=3532913 | doi=10.1177/000456328602300201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3532913  }} </ref>
OR
** [[Alpha-fetoprotein]] ([[AFP]])
*An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
** [[Blood urea nitrogen]] ([[BUN]])
*[Test] is usually normal among patients with [disease name].
** [[Creatinine]] ([[Cr]])
*Laboratory findings consistent with the diagnosis of [disease name] include
** [[Dehydroepiandrosterone-sulfate]] ([[DHEA-S]])
**[abnormal test 1]
** [[Estradiol]]
**[abnormal test 2]
** [[Erythrocyte sedimentation rate]] ([[ESR]])
**[abnormal test 3]
** [[Human chorionic gonadotropin]] ([[HCG]])
 
** [[Liver function tests]] ([[LFTs]])
*Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
** [[Prolactin]]
 
** [[Testosterone]]
==Laboratory Findings==
** [[Thyroid stimulating hormone]] ([[TSH]])
Lab findings for asymptomatic gynecomastia have a low yield, however, following lab work up can be done:<ref name="pmid17881754">{{cite journal| author=Braunstein GD| title=Clinical practice. Gynecomastia. | journal=N Engl J Med | year= 2007 | volume= 357 | issue= 12 | pages= 1229-37 | pmid=17881754 | doi=10.1056/NEJMcp070677 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17881754  }} </ref><ref name="pmid17090633">{{cite journal| author=Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H| title=Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. | journal=J Clin Endocrinol Metab | year= 2007 | volume= 92 | issue= 2 | pages= 405-13 | pmid=17090633 | doi=10.1210/jc.2006-1864 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17090633  }} </ref><ref name="pmid11158037">{{cite journal| author=Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging| title=Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging. | journal=J Clin Endocrinol Metab | year= 2001 | volume= 86 | issue= 2 | pages= 724-31 | pmid=11158037 | doi=10.1210/jcem.86.2.7219 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11158037  }} </ref><ref name="pmid3532913">{{cite journal| author=Ismail AA, Astley P, Burr WA, Cawood M, Short F, Wakelin K et al.| title=The role of testosterone measurement in the investigation of androgen disorders. | journal=Ann Clin Biochem | year= 1986 | volume= 23 ( Pt 2) | issue=  | pages= 113-34 | pmid=3532913 | doi=10.1177/000456328602300201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3532913  }} </ref>
* [[Alpha-fetoprotein]] ([[AFP]])
* [[Blood urea nitrogen]] ([[BUN]])
* [[Creatinine]] ([[Cr]])
* [[Dehydroepiandrosterone-sulfate]] ([[DHEA-S]])
* [[Estradiol]]
* [[Erythrocyte sedimentation rate]] ([[ESR]])
* [[Human chorionic gonadotropin]] ([[HCG]])
* [[Liver function tests]] ([[LFTs]])
* [[Prolactin]]
* [[Testosterone]]
* [[Thyroid stimulating hormone]] ([[TSH]])


==References==
==References==

Latest revision as of 23:49, 15 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Gynecomastia is diagnosed clinically after a thorough history and physical examination. A recent onset of gynecomastia with tenderness on the examination require the following laboratory studies: Serum concentrations of human chorionic gonadotropin (hCG)LHtestosterone, and estradiol. The hormonal levels may vary depending on the underlying cause.

Laboratory Findings

References

  1. Braunstein GD (2007). "Clinical practice. Gynecomastia". N Engl J Med. 357 (12): 1229–37. doi:10.1056/NEJMcp070677. PMID 17881754.
  2. Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H (2007). "Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement". J Clin Endocrinol Metab. 92 (2): 405–13. doi:10.1210/jc.2006-1864. PMID 17090633.
  3. Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR, Baltimore Longitudinal Study of Aging (2001). "Longitudinal effects of aging on serum total and free testosterone levels in healthy men. Baltimore Longitudinal Study of Aging". J Clin Endocrinol Metab. 86 (2): 724–31. doi:10.1210/jcem.86.2.7219. PMID 11158037.
  4. Ismail AA, Astley P, Burr WA, Cawood M, Short F, Wakelin K; et al. (1986). "The role of testosterone measurement in the investigation of androgen disorders". Ann Clin Biochem. 23 ( Pt 2): 113–34. doi:10.1177/000456328602300201. PMID 3532913.

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