Clinical Profiles, Occurrence, and Management of Adolescent Patients with HAIR-AN Syndrome (original) (raw)
Related papers
2016
HAIRAN syndrome is a very rare syndrome which manifests with hyperandrogenism, insulin resistance and acanthosis nigricans. The syndrome usually presents with symptoms during adolescent period of life time. These pattients can easily be misdiagnosed as polycystic ovary syndrome both of which has resembling signs and symptoms. Clinical examination, gynecological evaluation and laboratory investigations are mandatory to differentiate these two syndromes. Metabolic consequences of the syndrome increases the risk of cardiovasculary disease in the future life of these adolescent patients. Counseling about the importance of weight reduction and control of insulin resistance by utilization of medical treatment for menstrual irregularies and hirsutism are key steps during management of this syndrome.
Journal of the American Academy of …, 1996
Acanthosis nigricans is associated with many diseases, including internal malignancies, genetic disorders, and endocrine abnormalities. Insulin resistance frequently accompanies endocrine-associated acanthosis nigficans. We describe a patient with acanthosis nigricans associated with hyperandrogenism and extreme insulin resistance that spontaneously resolved after a marked decrease in insulin receptor antibodies. (J AM ACAD DERMATOL 1996;34: 892-7.) Acanthosis nigricans (AN) is broadly classified into malignant and benign forms, 1 with the latter divided into four distinct categories (Table 1). 2 Much attention has focused on malignant AN because it represents an ominous cutaneous marker for internal malignancy, particularly gastric adenocarcinoma. 1 Recent attention has been directed toward its benign endocrine associations (Table 1/). AN is a significant marker for insulin resistance OR). 3 We describe a patient with AN associated with hyperandrogenism (HA) and IR (HAIR-AN syndrome), that spontaneously resolved after disappearance of antibodies to the insulin receptors. CASE REPORT A 15-year-old black girl had a 1-month history of polyuria, polydipsia, decreased appetite, 16-pound weight loss, occasional vomiting, fatigue, and malaise. Her initial blood glucose level was 314 mg/dl, and urinalysis showed 3+ glucose and 1+ ketones. Examination revealed a well-developed girl who weighed 127 pounds (between the 50th and 75th percentiles) and was 65 inches tall (above the 75th percentile). She had markedly hyperpigmented, velvety to papillomatous plaques in intertriginous sites, especially the antecubital fossae, axillae, and posterior cervical region (Figs. 1 and 2). Multiple acrochordons were also present From the
Study of Adolescent Girls with Menstrualirregularities for Polycystic Ovaries and Insulin Resistance
2015
The perimenarcheal onset of polycystic ovarian syndrome (PCOS) has long been recognized, through both its pathophysiology and the frequent onset of hirsutism and menstrual irregularities in this age group. However, there is often a delay in diagnosing PCOS in adolescence because menstrual irregularity is frequently thought to be normal in the first 2 or 3 years after menarche, particularly if clinical signs of hyperandrogenism such as hirsutism or acne are mild or absent. This was a Cross-sectional Study consisting of 102 adolescent girls, aged 12 to 19 years, selected from patients attending the Gynecology Outpatient Clinic. In present study, level of insulin resistance along with markers of PCOS was assessed and compared in adolescent women with (cases) or without (controls) menstrual irregularities, a hall mark of PCOS. 18(35.29%) cases versus 01(1.96%) controls the Rotterdam criteria of PCOS. Clinical manifestations of hyper androgenism were not yet present in all cases who met ...
Polycystic ovary syndrome: Challenges in adolescence
2010
Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. PCOS typically develops during adolescence and is a heterogeneous syndrome classically characterized by features of anovulation combined with signs of androgen excess (hirsutism, acne). Increasing obesity in adolescents probably exacerbates signs of PCOS, contributing to its earlier recognition. Recognizing the features of this syndrome can be very challenging in adolescence. Although adolescents' concerns are often cosmetic, if left untreated these girls are at risk for diabetes, metabolic syndrome, and infertility as they mature. Efforts should be made to diagnose and treat PCOS to minimize the development of symptoms and prevent the onset of cardiovascular and metabolic disturbances. (A. Oliveira). Endocrinol Nutr. 2010;57(7):328-336 diagnosticar y tratar el SOP a fin de minimizar el desarrollo de los síntomas y prevenir la aparición de problemas cardiovasculares y metabólicos. & 2009 SEEN. Publicado por Elsevier España, S.L. Todos los derechos reservados.
International Journal of School Health, 2015
Background: Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder among women and is also the cause of infertility due to an-ovulation. Objectives: This study was carried out to determine the prevalence of PCOS phenotypes in Shiraz. Patients and Methods: In this cross-sectional study, 3190 female adolescents aging from 14 to 18 years were randomly selected from Shiraz high schools in 2009. Diagnosis of PCOS was carried out through history, examination according to oligomenorrhea (6 cycles or less in a year), and clinical signs of hyperandrogenism including hirsutism (Ferriman-allwey score of 6 and above), severe acne, and androgenic alopecia. Finally, 146 students entered into this study. The ultrasound was conducted based on Adams criteria .The data analyzed using SPSS-16 software andχ 2 and t statistical tests, and P < 0.05 was considered as statistically significant. Results: The prevalence of hirsutism, acne, alopecia, and oligomenorrhea was 3.2% (100 cases), 5% (235 cases), 4.2% (135 cases), and 4.6 % (144 cases), respectively. The incidence rate of menorrhagia was 9.2% (265 cases). Additionally, clinical hyperandrogenism phenotype and oligomenorrhea (HA, OA)were presented in 29 cases (19.9%), clinical Hyperandrogenism phenotype and Polycystic Ovary (HA ,PCO) in 45 cases (30.8%), Oligomenorrhea phenotype and Polycystic Ovary (OA, PCO) in 43 cases (29.5%), and clinical hyperandrogenism phenotype, polycystic ovary, and oligomenorrhea (HA, OA and PCO) in 21 cases (14.5%). Conclusions: Full-blown phenotype (hyper androgenic, Oligomenorrhea and polycystic ovary syndrome), Lowest frequency and phenotype (hyperandrogenic, polycystic ovary syndrome) was the most frequent in this population of Iranian girls. The risk of sex hormone turmoil, psychological effects of skin symptoms (acne and hirsutism), and the high complications of this syndrome in adolescent group necessitate further investigation.
ADOLESCENT POLYCYSTIC OVARY SYNDROME
Polycystic Ovary Syndrome (PCOS) is the most frequent endocrinopathy in women and is now being increasingly met with in adolescents. It is characterised by irregular cycles or amenorrhoea along with features of hyperandrogenism. This review focuses on the different definitions used and also describes the conclusions of the recent Amsterdam consensus workshop on adolescent PCOS. Insulin resistance and compensatory hyperinsulinaemia are seen in most cases of polycystic ovary syndrome and this close association with the metabolic syndrome is responsible for the public health importance of the problem. The importance of screening for PCOS in adolescence with a view to preventing future problems is highlighted. The review also includes the different modalities to be used in diagnosis and the management strategies to be followed in adolescent PCOS.
Comparative Management Methods for Adolescents With Polycystic Ovarian Syndrome: A Systemic Review
Curēus, 2024
Polycystic ovarian syndrome (PCOS) is a common endocrinological disorder affecting many adolescents and women of reproductive age worldwide. A diagnosis of PCOS in adolescence relies upon investigating each medical history independently and noting commonly associated symptoms, including obesity, insulin resistance, acne, menstrual abnormalities, and hirsutism. Many researchers are aiming to discover a methodology to help manage the symptoms associated with PCOS, especially in adolescents. This review will investigate management methods possible for adolescents with PCOS. Although the most preferred way to help reduce symptoms is through lifestyle modifications such as vigorous exercise and dietary regimens low in carbohydrates, pharmaceuticals are also offering promising results to adolescents with PCOS. Metformin, oral contraceptives, gonadotropin-releasing hormone (GnRH) antagonists, and other alternatives, including finasteride, eflornithine, fibroblast growth factors (FGFs), and vitamin D, are all shown to help improve insulin sensitivity and regulate menstrual cycles and reduce hirsutism. Epilatory and surgical measurements are also available; however, they are reserved for when all other methods fail and once adulthood or an appropriate age is reached. Although there are many pharmaceuticals available, it is necessary to evaluate each adolescent with PCOS uniquely and prescribe the appropriate pharmacotherapy regarding their symptoms.
The Diagnosis of Polycystic Ovary Syndrome during Adolescence
Hormone Research in Paediatrics, 2015
dress a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligoanovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls.