Biliopancreatic diversion as a novel approach to the HAIR-AN syndrome.
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.


CONCLUSIONS
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.
Manco
Melania
M
Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy. melaniamanco@tiscali.it
Castagneto
Marco
M
Nanni
Giuseppe
G
Guidone
Caterina
C
Tondolo
Vincenzo
V
Greco
Aldo Virgilio
AV
Gasbarrini
Giovanni
G
Mingrone
Geltrude
G
D000052:Acanthosis Nigricans / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications / Q000175:diagnosis*; D007333:Insulin Resistance; D009767:Obesity, Morbid / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013577:Syndrome; D016896:Treatment Outcome; D015431:Weight Loss