Kępczyńska-Nyk Anna, Muszel Marta, Radziszewski Mikołaj, Wocial Kamil
Medical University of Warsaw, Poland: Department of Internal Medicine and Endocrinology.
Medical University of Warsaw, Poland: Student's Scientific Circle "Endocrinus", Department of Internal Medicine and Endocrinology.
Pol Merkur Lekarski. 2016 Sep 29;41(243):141-144.
19-year-old hirsute woman with obesity, skin lesions with features of acanthosis nigricans around neck, armpits, thoracic cage and wrists escalating for couple of months, elevated testosterone and insulin plasma levels was admitted to hospital to perform diagnostic approach. The final diagnosis was hyperandrogenism-insulin resistance-acanthosis nigricans syndrome (HAIR-AN syndrome), considered as a subtype of policystic ovary syndrome (PCOS) and impaired glucose tolerance. HAIR-AN is characterized by coexistence of: hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). These symptoms are result of increased insulin and androgens levels. Due to accompanying complications (obesity, hyperglycemia, hyperlipidemia, infertility) patients with HAIR-AN syndrome should be monitored and treated. Rarely acanthosis nigricans, especially when occurs rapidly and extensively, may be a paraneoplastic disorder. Life style modification with BMI reduction was recommended and metformin, a drug improving sensitivity to insulin, was administered. Patient should be monitored due to possible complications of obesity, diabetes and hyperinsulinemia.
一名19岁多毛肥胖女性,颈部、腋窝、胸廓和手腕周围出现具有黑棘皮病特征的皮肤病变且持续数月,睾酮和胰岛素血浆水平升高,入院进行诊断检查。最终诊断为高雄激素血症-胰岛素抵抗-黑棘皮病综合征(HAIR-AN综合征),该综合征被认为是多囊卵巢综合征(PCOS)的一种亚型且伴有糖耐量受损。HAIR-AN的特征是同时存在:高雄激素血症(HA)、胰岛素抵抗(IR)和黑棘皮病(AN)。这些症状是胰岛素和雄激素水平升高的结果。由于伴有肥胖、高血糖、高血脂、不孕等并发症,HAIR-AN综合征患者应接受监测和治疗。黑棘皮病很少见,尤其是当它迅速广泛出现时,可能是一种副肿瘤性疾病。建议通过改变生活方式降低体重指数,并给予二甲双胍,一种可提高胰岛素敏感性的药物。由于肥胖、糖尿病和高胰岛素血症可能引发并发症,应对患者进行监测。