Endocrine Abstracts

Introduction: Hirsutism is a frequent reason for consultation, it is defined by the presence of terminal hair with male distribution in women, it is however essential to determine the cause, since it can reveal a serious underlying pathology and as it may be due to a benign cause see idiopathic in some cases. Idiopathic hirsutism is second in line to polycystic ovary syndrome in the etiological search for hirsutism. The objective of this study is to describe the clinical and paraclinical aspects of idiopathic hirsutism in patients.

Patients and Methods: This is a retrospective and descriptive study of 30 patients followed for idiopathic hirsutism at the Endocrinology-Diabetology-Nutrition Department of the Mohammed VI University Hospital center in Oujda. The collected data were analyzed by SPSS-version-21 software. All patients benefited from a biological exploration of the adrenal gland (synacthene test, 24-hour urinary cortisol level), and a pelvic ultrasound.

Results: Idiopathic hirsutism represents only 20% of the causes of hirsutism in our series, the average age of our patients was 24.9±5.1 years [16-35 years]. Hirsutism appeared during puberty in 33.3% of cases and after puberty in 50% of cases, it was mild in 33.3%, moderate in 43.3% and severe in 23.3% of cases, with an average Ferriman and Gallwey score of 17.9±5.2. However, all the patients in our series did not have menstrual cycle disorders. Concerning the other minor signs of hyperandrogenism, acne and seborrhea were found in 56.7% and 20% of cases respectively. Overweight was reported in 33.3% and obesity in 13.4% of patients with 3 cases of metabolic syndrome (10%). Biological exploration showed a mean testosteronemia level of 0.47±0.24 ng/ml. Dyslipidemia was observed in 13.3% of cases, of which hypoHDLemia was the most frequent lipid anomaly (40%) and 27% of carbohydrate tolerance disorders.

Discussion and Conclusion: The etiologic investigation of hirsutism requires careful exploration for an accurate diagnosis and to rule out any adrenal or ovarian causes before retaining the diagnosis of idiopathic hirsutism and thus to guide the therapeutic management. This study shows that metabolic disturbances have been demonstrated in these patients, but their prevalence remains low, which is consistent with the data reported in the literature. Other studies on a larger number of patients should be carried out to study insulin resistance in women followed for idiopathic hirsutism in order to establish new and more effective therapeutic strategies.