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Drug-induced gynaecomastia — RACP Paediatrics MCQ

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EasyEndocrineDrug-induced gynaecomastiaRACP Paediatrics

A 15-year-old boy develops gynaecomastia after being started on spironolactone for acne. What is the most likely mechanism?

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Correct answer: DMedication-induced

Spironolactone is a well-known cause of gynaecomastia due to its anti-androgen effects (blocking the androgen receptor and inhibiting testosterone synthesis) and weak oestrogenic activity. Other common medication causes include ketoconazole, cimetidine, and marijuana. Discontinuation of the offending agent usually leads to resolution.

Reference: Australian Therapeutic Guidelines – 2024; RACP Paediatric Curriculum – Endocrine