A 64-year-Old patient assigned male at birth with COPD and worsening dyspnea while on estrogen and antiandrogen agents

Gustavo A Cortes-Puentes; Caroline J Davidge-Pitts; Cesar A Gonzalez; Megan M Dulohery Scrodin; Cassie C Kennedy; Kaiser G Lim

doi:10.1016/j.rmcr.2023.101876

A 64-year-Old patient assigned male at birth with COPD and worsening dyspnea while on estrogen and antiandrogen agents

Respir Med Case Rep. 2023 May 29:44:101876. doi: 10.1016/j.rmcr.2023.101876. eCollection 2023.

Authors

Gustavo A Cortes-Puentes¹, Caroline J Davidge-Pitts², Cesar A Gonzalez³, Megan M Dulohery Scrodin¹, Cassie C Kennedy¹, Kaiser G Lim¹

Affiliations

¹ Mayo Clinic, Rochester MN, Division of Pulmonary and Critical Care Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
² Mayo Clinic, Rochester MN, Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic Transgender and Intersex Specialty Care Clinic (TISCC), 200 First Street SW, Rochester, MN, 55905, USA.
³ Mayo Clinic, Rochester MN, Department of Psychiatry and Psychology, Department of Family Medicine, Mayo Clinic Transgender and Intersex Specialty Care Clinic (TISCC), 200 First Street SW, Rochester, MN, 55905, USA.

Abstract

Among patients with COPD, ventilatory inefficiency in response to exercise can be due to respiratory muscle dysfunction or expiratory flow limitation causing air-trapping and dynamic hyperinflation. We discuss a case of severe ventilatory limitation in response to exercise due to reduced respiratory muscle mass in the setting of gender-affirming hormone therapy (GAHT), and how the interpretation of pulmonary function testing (PFT) and respiratory symptoms among transgender and gender diverse (TGD) patients can be influenced by GAHT.

Keywords: COPD; Chronic obstructive pulmonary disease; Gender affirming care; LVRS; Lung volume reduction surgery; PFT; Personalized medicine; Pulmonary function testing; Pulmonary mechanics; Transgender.

Publication types

Case Reports