HAIR-AN syndrome


A very rare syndrome that affects females only and is characterized mainly by insulin resistance, dark velvety patches of skin and increased male hormone production in females.


* Enlarged clitoris * Increased libido * Infertility * Irregular menstruation * Increased blood pressure * Glucose intolerance * Increased blood lipids * Increased hair on chest * Increased hair on face * Increased hair on chin * Oily skin * Acne * Malodorous male perspiration * Deep voice * Obesity * Increased body musculature * Loss of scalp hair * Increased thirst * Increased urination


* Impaired fasting glucose * Medications –Corticosteroids are a common cause –Common medications include growth hormone, estrogen (including oral contraceptives), nicotinic acid, salicylates and NSAIDs, thiazide and loop diuretics, phenytoin, and epinephrine * Diabetes mellitus type I –Diabetic ketoacidosis * Diabetes mellitus type II * Pancreatic disease –Acute or chronic pancreatitis –Pancreatectomy –Pancreatic carcinoma –Hemochromatosis –Cystic fibrosis o Increased counter-regulatory hormones associated with acute disease –Myocardial infarction –Stroke or other neurologic disease –Renal insufficiency –Hepatic insufficiency * Acromegaly * Cushing's syndrome * Pheochromocytoma * Hyperthyroidism (thyroid storm) * Glucagonoma * Gestational diabetes * Amyloidosis


Further workup may include a CBC, urinalysis, chemistry panel, glucose tolerance test, plasma cortisol, free T 4 , TSH, plasma and urine catecholamines, skull x-ray, vanillylmandelic acid (VMA) , and endocrinology consult.