07-18-2008, 07:46 PM
A 19-year-old college student comes to the physician because of progressive hair growth over her face and body since the age of 16 years. She also has acne and oily skin. Menses have occurred at 30- to 90- day intervals since menarche at the age of 14 years. She has no history of serious illness and takes no medications. She is 168 cm (5 ft 6 in) tall and weighs 88 kg (193 lb); BMI is 31 kg/m2. Her temperature is 37.2°C (99°F), pulse is 72/min, respirations are 16/min, and blood pressure is 120/80 mm Hg. Physical examination shows coarse, pigmented hair over the chin and upper lip, around both nipples, and along the midline of the lower abdomen. The remainder of the examination, including pelvic examination, shows no abnormalities. Serum studies show:
Fasting glucose 95 mg/dL
Fasting insulin 7.5 μU/mL (N=11“240)
Dehydroepiandrosterone sulfate 3 μg/mL (N=0.5“5.4)
Follicle-stimulating hormone 8 mIU/mL
17α-Hydroxyprogesterone 160 ng/dL (N=20“300)
Luteinizing hormone 10 mIU/mL
Testosterone 4.2 nmol/L (N
Fasting glucose 95 mg/dL
Fasting insulin 7.5 μU/mL (N=11“240)
Dehydroepiandrosterone sulfate 3 μg/mL (N=0.5“5.4)
Follicle-stimulating hormone 8 mIU/mL
17α-Hydroxyprogesterone 160 ng/dL (N=20“300)
Luteinizing hormone 10 mIU/mL
Testosterone 4.2 nmol/L (N