title: Biliopancreatic diversion as a novel approach to the HAIR-AN syndrome.
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.
  
  
  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.
authors.affiliation: Department of Internal Medicine, Catholic University, School of Medicine, Rome, Italy. melaniamanco@tiscali.it
authors.forename: Melania
authors.initials: M
authors.lastname: Manco
authors.forename: Marco
authors.initials: M
authors.lastname: Castagneto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nanni
authors.forename: Caterina
authors.initials: C
authors.lastname: Guidone
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tondolo
authors.forename: Aldo Virgilio
authors.initials: AV
authors.lastname: Greco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Geltrude
authors.initials: G
authors.lastname: Mingrone
mesh_terms: 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