title: Severe hyperandrogenemia and insulin resistance in a 12-year-old girl.
abstract: BACKGROUND
  Signs of androgen excess are common complaints of adolescents and young adults. Rapid onset/progression of hyperandrogenism or virilization should prompt further investigation to exclude an androgen-secreting tumor.
  
  
  METHODS
  We report the case of an obese young adolescent girl who presented with hirsutism, deepened voice, oligomenorrhea, marked acanthosis nigricans, and rapidly increasing testosterone and insulin levels. Imaging studies were negative for both ovarian and adrenal masses. She was successfully treated with continuous combined oral contraceptives. Investigation, treatment, and outcome are reviewed.
  
  
  CONCLUSIONS
  This case demonstrates that patients with PCOS may present with a testosterone > 200 ng/dL and that severe hyperinsulinemia can be associated with rapid progression of hyperandrogenism.
authors: Division of Adolescent and Young Adult Medicine, Children's Hospital Boston, Boston, MA, USA. maude.veilleux-lemieux@mail.chuq.qc.ca
authors: Maude
authors: M
authors: Veilleux-Lemieux
authors: Amy Desrochers
authors: AD
authors: DiVasta
mesh_terms: D002648:Child; D004967:Estrogens / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications; D006946:Hyperinsulinism / Q000097:blood / Q000150:complications / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D013739:Testosterone / Q000097:blood
chemical_list: D004967:Estrogens; D007004:Hypoglycemic Agents; D013739:Testosterone; D004997:Ethinyl Estradiol; D008687:Metformin