Hyperandrogenism insulin resistance-acanthosis nigricans syndrome in a female adolescent with migraine: A case report

The case study explores the extreme manifestation of polycystic ovary syndrome known as hyperandrogenism insulin resistance-acanthosis nigricans (HAIR-AN) syndrome in patients with migraine, which is marked by hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). Typically affecting women during their reproductive years, with a higher prevalence observed among adolescents, HAIR-AN syndrome’s aetiology is multifaceted, involving genetic and environmental factors, including the related seborrhoea, acne, hirsutism and alopecia syndrome. The report details the case of an 18-year-old female presenting with HAIR-AN syndrome, demonstrating symptoms such as migraine, obesity, acne, hirsutism and AN, which manifested during puberty. Despite symptom onset in adolescence, diagnosis was delayed until adulthood. Clinical evaluation revealed obesity, HA and IR, with laboratory tests confirming diabetes. The case suggests a potential link between IR-induced diabetes and the development of migraine symptoms. Treatment encompasses a multifaceted approach involving antiandrogen therapy, weight management strategies, migraine treatment and medications such as metformin used to address IR and orlistat, targeting obesity. Emphasis is placed on the significance of early diagnosis and intervention in endocrine disorders with HA to enhance treatment efficacy. The complex interplay between hormonal and metabolic dysregulation in HAIR-AN syndrome is highlighted, advocating for a multidisciplinary treatment approach. Continued research efforts are required to refine diagnostic modalities and treatment strategies, particularly in the adolescent population.