Biliopancreatic Diversion as a Novel Approach to the HAIR-AN Syndrome

Authors: Manco, Melania; Castagneto, Marco; Nanni, Giuseppe; Guidone, Caterina; Tondolo, Vincenzo; Greco, Aldo Virgilio; Gasbarrini, Giovanni; Mingrone, Geltrude

Source: Obesity Surgery, Volume 15, Number 2, February 2005 , pp. 286-289(4)

Publisher: Springer

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Abstract:

Background. The HAIR-AN syndrome is a rare multisystem disorder in women, that consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). The IR is likely due to a primary defect of the insulin receptor.

Methods: We report the case of a 42-year-old Caucasian woman with HAIR-AN syndrome, impaired glucose tolerance (IGT), mild hyperlipemia, and hypertension, who underwent biliopancreatic diversion (BPD).

Results: Within 24 months follow-up after BPD, impaired glucose tolerance, mild hyperlipemia, and hypertension completely reversed. Although insulin sensitivity, estimated by the euglycemic hyperinsulinemic clamp, did not improve, signs and symptoms of hyperandrogenism and acanthosis nigricans resolved fully.

Conclusion: In HAIR-AN syndrome, malabsorptive bariatric surgery is effective in improving hyperandrogenism and acanthosis nigricans, with noteworthy esthetic consequences. BPD was followed by disappearance of co-morbidities of the syndrome, such as IGT, hypertension and hyperlipemia.

Keywords: HAIR-AN SYNDROME; INSULIN RESISTANCE; BILIOPANCREATIC DIVERSION; BARIATRIC SURGERY; ACANTHOSIS NIGRICANS; HYPERANDROGENISM; MORBID OBESITY

Document Type: Case report

DOI: http://dx.doi.org/10.1381/0960892053268435

Affiliations: 1: Departments of Internal Medicine and 1 Surgery, Catholic University, School of Medicine, Rome, Italy

Publication date: 2005-02-01

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