A case of hyperinsulinemic obese female adolescent with virilization.
- Author:
In Mee BAEK
1
;
Ji Yeon LIM
;
Hey Soon PARK
Author Information
1. Department of Family Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Korea.
- Publication Type:Case Report
- Keywords:
obese girl;
virilization;
hyperinsulinemia;
hyperandrogenemia
- MeSH:
Acanthosis Nigricans;
Adolescent*;
Behavior Therapy;
Cardiovascular Diseases;
Chungcheongnam-do;
Female*;
Fluoxetine;
Hirsutism;
Humans;
Hyperandrogenism;
Hyperinsulinism;
Incidence;
Insulin Resistance;
Medroxyprogesterone Acetate;
Menstrual Cycle;
Obesity;
Obesity, Abdominal;
Obesity, Morbid;
Risk Factors;
Virilism*;
Weight Gain
- From:Journal of the Korean Academy of Family Medicine
1998;19(12):1419-1427
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Being obese during adolescence leads to undue physical or psychological problems and may increase the incidence of cardiovascular disease or endocrinological disorders. Recently authors have experienced a case of hyperinsulinemic obese girl with virilization. We report it with a review of the literature. CASE: A 17-year old female came into 'obesity clinic' of Asan Medical Center due to weight gain. She had virilizing feature, hirsutism, underdeveloped female sexual characteristics, and acanthosis nigricans. Work-up by laboratory tests and imaging studies showed very severe obesity with metabolic disturbances, and hyperandrogenism with hyperinsulinemia. Treatment for obesity was multidisciplinary method including behavior modification, calorie restriction, exercise, and medication with fluoxetine 40mg po qd, and for hyperandrogenism, provera 10mg po qd was described. CONCLUSIONS: Severe hyperinsulinemia in obese female leads to male-type hirsutism, disturbance of menstrual cycle, abdominal obesity, and cardiovascular disorders. One of the physical findings of hyperinsulinemia or insulin resistance is acanthosis nigricans. So, if an female obese patient have acanthosis nigricans with hyperinsulinemia, should be assessed and treated for risk factors of cardiovascular disorders and hormonal disturbances.