J Korean Acad Fam Med.  1998 Dec;19(12):1419-1427.

A case of hyperinsulinemic obese female adolescent with virilization

• Baek IM
• Lim JY
• Park HS

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.

Keyword

obese girl; virilization; hyperinsulinemia; hyperandrogenemia

MeSH Terms

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
Fluoxetine
Medroxyprogesterone Acetate