Blood Levels of Gonadotropins and Gonadal Hormones in Gynecomastia Associated with Chronic Hemodialysis

Five adult men who developed gynecomastia or tender breasts while undergoing chronic hemodialysis for chronic renal failure all had elevated serum luteinizing hormone (LH) and normal plasma testosterone (T). Four had elevated serum follicle-stimulating hormone (FSH) but only one had an elevated serum prolactin. In no case was plasma estradiol (E2) elevated. One year later, when the gynecomastia had largely disappeared, the level of LH was lower in 2 of 4 patients but remained slightly elevated in all four, while the level of FSH had fallen to normal in 3 of 4 patients. The cause of the gynecomastia is not clear but it is not due to elevated levels of E2 or prolactin or to an elevated ratio of E2 to T; it may be related to elevated FSH, LH, or both.