HAIR-AN Syndrome: Inside Story

ABSTRACT

15-year-old adolescent girl presented with weight gain, irregular menstrual cycle, skin lesions suggestive of acanthosis nigricans and hirsutism. On evaluation, she was found to have elevated testosterone levels with normal FSH, LH and fasting blood sugar, decreased glucose insulin index suggestive of Insulin resistance. In view of above features, diagnosis of hyperandrogenism-insulin resistance-acanthosis nigricans syndrome (HAIR-AN syndrome) was made. This syndrome is considered as a sub-type of polycystic ovary syndrome (PCOS). HAIR-AN syndrome has varied presentation and is usually seen by primary care physician, gynaecologist or dermatologist. Life style modification with weight reduction and drugs such as metformin helps in alleviating the symptoms. With limited resources in our country, diagnosis is frequently delayed leading to systemic complications. Early diagnosis and appropriate treatment would help in preventing complications of obesity, insulin resistance leading to coronary artery disease, Type 2 diabetes mellitus, hyperlipidemia. Depression and suicidal behavior may be associated with it and should be aggressively addressed in young adults suffering from HAIR-AN syndrome.