Pregnancy after treatment with the insulin-sensitizing agent troglitazone in an obese woman with the hyperandrogenic, insulin-resistant acanthosis nigricans syndrome.

Abstract

OBJECTIVE:

To report a case of unassisted pregnancy after 5 months of troglitazone treatment in a severely hyperandrogenic, insulin-resistant woman with acanthosis nigricans (HAIR-AN) previously managed with depot leuprolide acetate (LA) plus oral contraceptive and dexamethasone therapy.

DESIGN:

Case report.

SETTING:

Private infertility clinic.

PATIENT(S):

A 28-year-old African-American woman with excessive obesity (body mass index = 42 kg/m2) and HAIR-AN syndrome.

INTERVENTION(S):

Androgen suppression with depot LA plus oral contraceptive and dexamethasone therapy, troglitazone treatment resulting in normalization of fasting insulin and testosterone, spontaneous menses, and an unassisted pregnancy.

MAIN OUTCOME MEASURE(S):

Luteinizing hormone and testosterone concentrations, fasting insulin and glucose levels, insulin-glucose ratios, hCG levels, and ultrasound examinations.

RESULT(S):

Spontaneous menses followed by an intrauterine pregnancy after 5 months of treatment with troglitazone, an insulin-sensitizing agent, in a woman with severe HAIR-AN syndrome whose hyperandrogenism previously could be normalized only with depot LA plus oral contraceptive therapy and dexamethasone.

CONCLUSION(S):

Troglitazone treatment resulted in attenuation of both hyperinsulinemia and hyperandrogenism in an obese woman with HAIR-AN and resulted in resumption of menses and a spontaneous pregnancy.

• Authors: K E Elkind-Hirsch, R B McWilliams
• Journal: Fertility and sterility (Fertil Steril) Vol. 71 Issue 5 Pg. 943-7 (May 1999) ISSN: 0015-0282 [Print] United States
• PMID: 10231062 (Publication Type: Case Reports, Journal Article)

Chemical References

• Blood Glucose
• Chromans
• Gonadal Steroid Hormones
• Hypoglycemic Agents
• Insulin
• Thiazoles
• Thiazolidinediones
• Troglitazone

Topics

• Acanthosis Nigricans (blood, complications, physiopathology)
• Adult
• Blood Glucose (metabolism)
• Chromans (therapeutic use)
• Female
• Gonadal Steroid Hormones (blood)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulin (blood)
• Insulin Resistance
• Obesity (blood, complications, physiopathology)
• Pregnancy
• Thiazoles (therapeutic use)
• Thiazolidinediones
• Troglitazone