Key result
Testosterone administration in a 30-year-old undergoing female-to-male sex reassignment unmasked a latent Brugada syndrome ECG pattern, which disappeared upon suspension of the hormone.
Why the study?
Although the pathophysiological mechanism of Brugada syndrome is unknown, its male prevalence suggests a possible hormonal involvement.
Does testosterone administration trigger the ECG manifestation of Brugada syndrome in a patient undergoing female-to-male sex reassignment?
Case Report (n=1)
No
Does testosterone administration trigger the ECG manifestation of Brugada syndrome in a patient undergoing female-to-male sex reassignment?
This case report supports the hypothesis that testosterone is involved in the ECG manifestation of Brugada syndrome, potentially explaining its higher prevalence in males.
May prompt ECG surveillance with testosterone; hypothesis-generating and should not yet change practice.
Background The Brugada syndrome, diagnosed by a typical electrocardiographic pattern, is a genetic condition characterised by an increased risk of potentially lethal ventricular arrhythmias and sudden cardiac death. Even if its pathophysiological mechanism is unknown, its prevalence in male suggested a possible hormonal involvement. Case presentation In this case involving a woman who underwent a female-to-male sex reassignment, we documented that testosterone administration was able to switch on and, when stopped, to switch off a latent pattern of Brugada. Conclusions Our observation strongly supports a possible involvement of testosterone in the ECG manifestation of Brugada syndrome even if the general low prevalence of the Brugada syndrome does not support to screen every female-to-male sex reassignment.
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Vivona et al. (2020) conducted a case report in Latent Brugada syndrome (n=1). Testosterone therapy vs. Suspension of testosterone was evaluated on ECG manifestation of Brugada pattern. Testosterone administration in a 30-year-old undergoing female-to-male sex reassignment unmasked a latent Brugada syndrome ECG pattern, which disappeared upon suspension of the hormone.
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