Resolution Of Seasonal Allergies By Testosterone Replacement Therapy In A Hypogonadal Male Patient: A Case Report

ABSTRACT Objective: To describe a case of hypogonadism where testosterone replacement therapy relieved seasonal allergy signs and symptoms, eliminating the need for steroid treatment. Methods: We present the clinical and laboratory findings of a patient with hypogonadism (primary testicular failure) in which seasonal allergy symptoms and signs were resolved by testosterone replacement therapy. The report tries to explain the mechanism by which testosterone treatment in a hypogonadal patient can resolve seasonal allergies. Results: A 50-year-old male patient with past medical history of vitamin D deficiency, hyperlipidemia, and seasonal allergies for 20 years was referred with diagnosis of primary testicular failure. Testosterone replacement therapy with AndroGel normalized his testosterone level and resolved his testicular failure symptoms and, in addition, led to the resolution of his seasonal allergies in a follow-up at 2 years. The authors conjecture that testosterone therapy in this patient contributed to resolution of his seasonal allergies due to its impact on the immune system through the suppression of natural killer cell proliferation and the stimulation of anti-inflammatory cytokine production, regulatory T cell differentiation, basal corticosterone levels, and possibly the regulatory impact of vitamin D on the immune system. Conclusion: To the best of our knowledge, this is the first case report to describe the resolution of seasonal allergies in a hypogonadal male patient following testosterone replacement. This report motivates further studies on anti-inflammatory effects of testosterone in hypogonadal patients with seasonal allergies. Abbreviations: IL interleukin; NK natural killer; Tregs regulatory T cells