Clinical case of hyperandrogenism in a patient with Itsenko-Cushing disease

Abstract

Relevance: Hyperandrogenism syndrome (HAS) is a group of endocrine disorders characterized by increased levels of male hormones (androgens) in women. HAS has excellent social and public significance, and the relevance of studying HAS is determined by several medical factors: high prevalence (over 10% in the female population), significant impact on the quality of life, connection with the endocrine form of infertility, as well as the high frequency of concomitant metabolic diseases (obesity, diabetes mellitus - type 2 diabetes, atherosclerosis).
Clinical manifestations of hyperandrogenism include hirsutism, seborrhea, acne, androgenetic alopecia, and virilization.
The study aimed to consider the differential diagnosis of hyperandrogenic conditions in various endocrinopathies on the example of a clinical case of HAS in a patient with Itsenko-Cushing disease.
Materials and Methods: This article reviews a clinical case associated with HAS in a patient with Cushing's disease. The patient consulted a cosmetologist with complaints of acne, hirsutism, and a 20 kg weight gain, which is a common manifestation of this syndrome. The manifestation of symptoms significantly affected the patient's psychological state, just as before the illness, the girl worked as a model.
Due to the ineffectiveness of drug therapy as well as various cosmetic procedures and the increase in symptoms such as facial puffiness, fat deposits on the neck and shoulders, and stretch marks in the armpit area, she was referred to an endocrinologist.
Results: During the differential diagnosis, taking into account the hyperandrogenism syndrome and based on the clinical signs of hypercortisolism, the patient was diagnosed with Itsenko-Cushing disease.
Conclusion: Since the phenotype of this syndrome is quite extensive, and the incidence of acne exceeds the incidence of hirsutism, patients can, therefore, be treated for a long time only by a cosmetologist or dermatologist. An accurate and structured diagnosis prevents delays in establishing the correct diagnosis, beginning targeted treatment, and preventing possible complications. An individualized approach to HAS is critical to ensuring optimal clinical and psychological patient outcomes.