Intractable early childhood obesity as the initial sign of insulin resistant hyperinsulinism and precursor of polycystic ovary syndrome.

Abstract

OBJECTIVE:

We report that intractable early childhood obesity may be associated with severe insulin resistance syndromes (pseudo-Cushing's syndrome and pseudo-acromegaly) and precede polycystic ovary syndrome (PCOS).

STUDY DESIGN/RESULTS:

Patient 1 had prepubertal obesity followed by early puberty and was diagnosed with pseudo-Cushing's syndrome and insulin resistance at 10.3 years. Oligomenorrhea, androgen excess, and type 2 diabetes mellitus (DM2) emerged at 13.5 years. Patient 2 developed intractable prepubertal obesity followed by atypical true sexual precocity and pseudo-Cushing's syndrome in early childhood. By 11.3 years, oligomenorrhea, androgen excess, and DM2 had appeared. Patient 3 had prepubertal overgrowth in weight and height and was diagnosed with pseudo-acromegaly, menstrual irregularity, androgen excess, and impaired glucose tolerance at 14.3 years of age. Patient 4 had prepubertal overgrowth that evolved into pseudo-acromegaly, insulin resistance, secondary amenorrhea, and androgen excess at 15.6 years.

CONCLUSIONS:

Intractable prepubertal obesity was recognized to culminate in early childhood pseudo-Cushing's syndrome or pseudo-acromegaly, which are manifestations of insulin-resistant hyperinsulinism, and to herald adolescent PCOS.

• Authors: Elizabeth E Littlejohn, Roy E Weiss, Dianne Deplewski, Deborah V Edidin, Robert Rosenfield
• Journal: Journal of pediatric endocrinology & metabolism : JPEM (J Pediatr Endocrinol Metab) Vol. 20 Issue 1 Pg. 41-51 (Jan 2007) ISSN: 0334-018X [Print] Germany
• PMID: 17315528 (Publication Type: Case Reports, Journal Article)

Topics

• Adolescent
• Child
• Cushing Syndrome (pathology)
• Female
• Humans
• Hyperinsulinism (diagnosis, etiology)
• Insulin Resistance
• Obesity (complications, diagnosis, pathology)
• Polycystic Ovary Syndrome (diagnosis, etiology)
• Puberty, Precocious (pathology)
• Time Factors