Gynecomastia in a Rheumatoid Arthritis Patient; a Rare Side Effect of Methotrexate Therapy

We are reporting a case of a 51-year-old male patient with 3-year history of Rheumatoid Arthritis who developed gynecomastia 2 - 3 months after starting Methotrexate (MTX) therapy, without folate supplementation. Two months after stopping MTX therapy and initiating folate supplementation, gynecomastia started resolving. Very few cases of gynecomastia due to MTX therapy have been reported worldwide, although it is a rare yet a significant occurrence and should always be considered in male patients with Rheumatoid Arthritis.