Type B Insulin Resistance Masquerading as Ovarian Hyperthecosis.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 27911591.
- Also identified by DOI 10.1210/jc.2016-3674 and PMC identifier 5470776.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Hyperinsulinemia can lead to pathologic ovarian growth and androgen production. A 29-year-old woman developed an autoantibody to the insulin receptor (type B insulin resistance), causing extreme insulin resistance and hyperinsulinemia. Testosterone levels were elevated to the adult male range. Treatment with gonadotropin-releasing hormone (GnRH) analog led to normalization of testosterone, despite persistent extreme insulin resistance. This case demonstrates that gonadotropins are necessary for insulin to cause pathologic ovarian androgen production. Suppression of gonadotropins with GnRH analogs may be a useful therapeutic option in patients with severe hyperandrogenism or ovarian enlargement because of hyperinsulinemia.
Medical subject headings
- Hyperandrogenism
- Hyperinsulinism
- Insulin Resistance
- Ovarian Diseases
- Receptor, Insulin