Rabson-Mendenhall syndrome: a rare case of severe insulin resistance

Authors

  • Farhana Afrooz FCPS final part student, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Faria Afsana Assistant Professor, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Mohammod Feroz Amin Associate Professor, Department of Endocrinology, BIRDEMGeneral Hospital, Dhaka, Bangladesh
  • Sadia Jabeen Mustafaa FCPS final part student, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Rushda Sharmin Binte Rouf Registrar, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Kazi Nazmul Hossain Registrar, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
  • Faruque Pathan Professor, Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/birdem.v12i1.57232

Keywords:

acanthosis nigricans, diabetes, insulin receptor, insulin resistance, Rabson-Mendenhall syndrome

Abstract

Insulin resistance syndromes are a heterogeneous group of disorders with variable clinical phenotypes, associated with increased blood glucose and insulin levels. A 20-year-old female, diabetic for 12 years, reported with hyperglycemia not responding to high dose of insulin; therefore, insulin dosage was increased but did not lead to appropriate glycemic control. Investigations revealed hyperglycemia (random blood glucose 23 mmol/L) glycosylated hemoglobin (HbA1c) 9.2%. Ultrasonogram of the abdomen showed prominent ovaries with fatty liver. Echocardiography revealed mild mitral, pulmonary and tricuspid regurgitation and pulmonary hypertension. Based on the clinical features, skin changes and the onset of type 2 diabetes mellitus, Rabson-Mendenhall syndrome (RMS) was considered. In last admission, she was admitted for hyperglycemic control and treated with intravenous fluids, insulin infusion, metformin, pioglitazone, linagliptin, hydroxychloroquine, sulphonylurea, antibiotics. There is no complete cure for the condition and the current treatments are difficult and not very promising.

BIRDEM Med J 2022; 12(1): 83-87

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Published

2021-12-30

How to Cite

Afrooz, F. ., Afsana, F. ., Amin, M. F. ., Mustafaa, S. J. ., Binte Rouf, R. S. ., Hossain, K. N. ., & Pathan, F. . (2021). Rabson-Mendenhall syndrome: a rare case of severe insulin resistance. BIRDEM Medical Journal, 12(1), 83–87. https://doi.org/10.3329/birdem.v12i1.57232

Issue

Section

Case Reports