Endocrine Abstracts

HAIR-AN is a rarely recognized syndrome which is characterized by hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). In the course of the syndrome, anovulation and metabolic disorders can develop, too. It is therefore suggested by some authors that HAIR-AN is an extreme phenotype of the polycystic ovary syndrome (PCOS). Generally, considering wide spectrum of metabolic and endocrine disorders which can be associated with the syndrome, it still remains therapeutic challenge. We present a case of a 32-year-old woman with HAIR-AN syndrome in whom introduced treatment regimen including liraglutide therapy improved her metabolic and procreative status. The patient was admitted to the Endocrinology Clinic because of 3rd degree obesity (BMI 50.22 kg/m²), severe hirsutism, acanthosis nigricans and secondary amenorrhea. At that moment the patient was already treated with metformin which was prescribed by gynaecologist a few months prior to the hospitalization. In the laboratory tests, severe hyperandrogenemia, impaired glucose tolerance with hyperinsulinemia and atherogenic dyslipidemia were stated Hypercortisolemia, congenital adrenal hyperplasia or high prolactin level were ruled out. Eventually, the diagnosis of HAIR-AN syndrome was proposed. The treatment with metformin was continued. Low-calorie diet and systematic physical activity were recommended – the patient has undergone education in this field. Furthermore, as the therapy with only metformin did not improve patient’s health status, liraglutide (1.2 mg/day) was added to the treatment. After six month therapy, a 33 kg reduction in body weight was achieved with BMI decline to 33.2 kg/m². The patient started to menstruate again. She also observed hirsutism reduction. Clinical amelioration was accompanied by metabolic and hormonal profile improvement – decline in insulin glucose and androgens’ level; improved lipids’ profile. The presented case shows the importance of body loss in the treatment protocol for HAIR-AN syndrome and the role of liraglutide in the therapy. Liraglutide, a drug from the group of GLP-1 analogues, ameliorates the symptoms related to HAIR-AN most probably not only due to its potential in body mass reduction. Several small studies confirmed already improve in insulin resistance, decline in androgen levels and normalization of menstrual cycle in PCOS patients who received liraglutide. Based on the case presented, it seems that HAIR-AN patients would also profit from liraglutide therapy and thus such a therapy deserves attention.