Severe insulin resistance, diabetes mellitus, hypertriglyceridemia, and pseudoacromegaly.

Abstract

A 24-yr-old female student born of apparently normal, unrelated parents presented with severe abdominal pain and muscle cramps at the age of 20 yr. She had also noticed increasing hirsutism and well-developed muscles in her limbs despite making no special effort to exercise beyond her normal activities. These symptoms dated from about the age of 11 yr when she had attained menarche. Her menstrual periods were regular. On physical examination she was tall (179.5 cm) and weighed 74.9 kg with a BMl of 24.0 kg / m2. Her supine blood pressure was 130180 mmHg. She was muscular with welldeveloped leg muscles (Fig. She had a normal amount of subcutaneous fat on her face, abdomen, and chest, but had excessive fat around her neck (Fig. Acanthosis nigricans was noted in both axillae and groins (Fig. She also had moderate facial hirsutism and a male escutcheon, but no clitoromegaly or temporal hairline recession.