Veilleux-Lemieux Maude, DiVasta Amy Desrochers
Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Boston, MA, USA.
J Pediatr Adolesc Gynecol. 2012 Aug;25(4):e99-101. doi: 10.1016/j.jpag.2012.04.002.
Signs of androgen excess are common complaints of adolescents and young adults. Rapid onset/progression of hyperandrogenism or virilization should prompt further investigation to exclude an androgen-secreting tumor.
We report the case of an obese young adolescent girl who presented with hirsutism, deepened voice, oligomenorrhea, marked acanthosis nigricans, and rapidly increasing testosterone and insulin levels. Imaging studies were negative for both ovarian and adrenal masses. She was successfully treated with continuous combined oral contraceptives. Investigation, treatment, and outcome are reviewed.
This case demonstrates that patients with PCOS may present with a testosterone > 200 ng/dL and that severe hyperinsulinemia can be associated with rapid progression of hyperandrogenism.
雄激素过多的体征是青少年和年轻成年人常见的主诉。高雄激素血症或男性化的快速发作/进展应促使进一步检查以排除分泌雄激素的肿瘤。
我们报告了一名肥胖的年轻青春期女孩的病例，她出现多毛、声音变粗、月经过少、明显的黑棘皮病，以及睾酮和胰岛素水平迅速升高。影像学检查未发现卵巢和肾上腺肿块。她通过连续联合口服避孕药成功治愈。对检查、治疗及结果进行了回顾。
该病例表明，多囊卵巢综合征患者的睾酮水平可能>200 ng/dL，且严重高胰岛素血症可能与高雄激素血症的快速进展有关。
