DOI: 10.36347/sjmcr.2019.v07i01.024

Pages: 82-84

Andropause or late-onset hypogonadism (LOH) is characterized by particular symptoms and a low level of serum testosterone with advancing age, which has been documented in patients with type 2 diabetes. An 89-year-old man with slowly progressive insulin-dependent diabetes mellitus was admitted due to malnutrition and respiratory tract infection. After the treatment with antibiotics, he was diagnosed with active rheumatoid arthritis and was treated with prednisolone. The treatment with prednisolone was effective on the improvement of the levels of C-reactive protein, albumin and hemoglobin, while the improvement of the patient’s appetite loss was slow and limited. Since his serum free testosterone level was found to be as low as 2.2 pg/ml, 125 mg of testosterone enanthate was injected intramuscularly. Shortly after the injection, his appetite loss was improved and he obviously became active in receiving physical therapy. The second injection was less effective. It is thus suggested that the combination therapy of prednisolone and testosterone can be effective for elderly patients with chronic inflammation and LOH. It should be advised to proactively measure the testosterone levels in elderly patients, and more appropriate supplementation of testosterone for LOH as seen in the present case may be needed.