2016, Number 1-2
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Rev Hosp Jua Mex 2016; 83 (1-2)
El síndrome de hiperandrogenismo, insulinorresistencia y acantosis nigricans o síndrome de HAIR-AN. Presentación de siete casos y revisión de la literatura
Vargas-Hernández VM, Tovar-Rodríguez JM, Ferrer-Arreola LP, Loranca-Moreno P
Language: Spanish
References: 26
Page: 11-16
PDF size: 219.48 Kb.
ABSTRACT
Background. HAIR-AN syndrome identifies women with hyperandrogenism (HA), insulin-resistance (IR) and
acanthosis
nigricans (AN) associated with 1-5% with polycystic ovaries; these patients have, risk factors for
cardiovascular disease, hypertension, dyslipidemia, diabetes and some cancers. Clinically obese patients with
acne, hirsutism, chronic anovulation and infertility and metabolic syndrome. Most respond to dietary, hormonal
and insulin sensitizing operation. The aim of this work is to identify women with syndrome HAIR-AN.
Material and
methods. Investigated and characterized the clinical, biochemical and therapeutic aspects and review of the
literature; through retrospective analysis of patients with syndrome HAIR-AN in Hospital Juárez de México.
Results.
Age of the patients was 14-33 years with menarche between 10 and 15 years, all OPSO reported amenorrhea,
obesity, hirsutism, acne and AN, the ratio of FSH/LH › 2: 1 occurs in 57%, E2 levels were › 100% 40 pg,
testosterone › 2ng in 30%, 15% high prolactin, progesterone ‹ 1.24 ng 100%, the polycystic ovaries by
ultrasound as presented only 50%.
Conclusions. Most patients with this syndrome present with anovulation,
obesity and IR, and HA, consider that this entity is extreme or severe form of polycystic ovarian syndrome.
REFERENCES
Speroff L, Fritz MA. Anovulación y poliquistosis ovárica. Cap. 12. En: Speroff L, Fritz MA (eds.). Endocrinología ginecológica clínica y esterilidad. 2a ed. En: Edit. Lippincott Williams & Milkins; 2006, p. 476-83.
Barbieri RL, Ryan KJ. Hiperandrogenism, insulin-resistance and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol 1983; 147: 90-101.
Elmer KB, George RM. HAIR-AN syndrome: A multisystem challenge. Am Fam Physician 2001; 63(12): 2385-90.
Esperanza LE, Fenske NA. Hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) syndrome: spontaneous remission in a 15-year-old girl. J Am Acad Dermatol 1996; 34(5, Pt. 2): 892-97.
Kuroki R, Sadamoto Y, Imamura M, Abe Y, Higuchi K, Kato K, et al. Acanthosis nigricans with severe obesity, insulin resistance and hypothyroidism: improvement by diet control. Dermatology 1999; 198: 164-6.
Magsino CH Jr, Spencer J. Insulin receptor antibodies and insulin resistance. South Med J 1999; 92(7): 717-9.
Zemtsov A, Wilson L. Successful treatment of hirsutism in HAIR-AN syndrome using flutamide, spironolactone, and birth control therapy. Arch Dermatol 1997; 133(4): 431-3.
Conway GS, Jacobs HS. Clinical implications of hyperinsulinaemia in women. Clin Endocrinol 1993; 39(6): 623-32.
Schwartz RA, Janniger CK. Childhood acanthosis nigricans. Cutis 1995; 55(6): 337-41.
Dunaif A, Green G, Phelps RG, Lebwohl M, Futterweit W, Lewy L. Acanthosis nigricans, insulin action and hyperandrogenism: clinical, histolgical and biochemical findings. J Clin Endocrinol Metab 1991; 73(3): 590-5.
Norman RJ, Mahabeer S, Masters S. Ethnic differences in insulin and glucose response to glucose between white and Indian women with polycystic ovary syndrome. Fertil Steril 1995; 63(1): 58-62.
Reaven G. The metabolic syndrome or the insulin resistance syndrome? Different names, different concepts, and different goals. Endocrinol Metab Clin North Am 2004; 33(2): 283-303.
Yarak S, Bagatin E, Hassun KM, Parada MOAB, Talarico Filho S. Hiperandrogenismo e pele: síndrome do ovário policístico e resistência periférica à insulina. An Bras Dermatol 2005; 80(4): 395-410.
Cresswell J, Fraser R, Bruce C, Egger P, Phillips D, Barker DJ. Relationship between polycystic ovaries, body mass index and insulin resistance. Act Obstet Gynecol Scand 2003; 82(1): 61-4.
Cibula D, Cìfkovà R, Fanta M, Poledne R, Zivny J, Skibovà J. Increased risk of non-insulin dependent diabetes mellitus, arterial hypertension and coronary artery disease in perimenopausal women with a history of the polycystic ovary syndrome. Human Reprod 2000; 15(4): 785-9.
Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999; 22(1): 141-9.
Talbott EO, Zborowski JV, Sutton-Tyrrell K, McHugh-Pemu KP, Guzick DS. Cardiovascular risk in women with polycystic ovary syndrome. Obstet Gynecol Clin North Am 2001; 28(1): 111-33.
Cascella T, Palomba S, De Sio I, Manguso F, Giallauria F, De Simone B, et al. Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome. Hum Reprod 2008; 23(1): 153-9.
Balen A. Polycystic ovary syndrome and cancer. Hum Reprod Update 2001; 7(6): 522-5.
Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet 2003; 361(9371): 1810-2.
Pfeifer SM, Dayal M. Treatment of the adolescent patient with polycystic ovary syndrome. Obstet Gynecol Clin N Am 2003; 30(2): 337-52.
Huber-Buchholz MM, Carey DG, Norman RJ. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab 1999; 84(4): 1470-4.
Nestler JE. Metformin for the treatment of the polycystic ovary syndrome. N Engl J Med 2008; 358(1): 47-54.
McCarthy EA, Walker SP, McLachlan K, Boyle J, Permezel M. Metformin in obstetric and gynecologic practice: A review. Obstetr Gynecol Surv 2004; 59(2): 118-27.
Futterweit W. Polycystic ovary syndrome: clinical perspectives and management. Obstet Gynecol Surv 1999; 54(6): 403-13.
Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin Reprod Endocrinol 1997; 15(2): 111-22.