hair-an syndrome: a rare cause of hyper insulinemic state

Insulin resistance is categorized as type a or type b, depending on the etiology. hairan syndrome is a subtype of type a insulin resistance. it is characterized by high insulin resistance, hyperandrogenemia, and hyperinsulinemia. here, we present a 12-year-old girl who was lean during her first decade of life and came with complaints of gradual-onset weight gain, darkening of her neck and limbs, and roughening of her skin. menarche had not been attained. she had grade 4 acanthosis nigricans, thick coarse skin, and hirsutism.investigations revealed raised blood glucose, elevated testosterone, elevated fasting insulin, and raised homa-ir. with biochemical evidence of hyperandrogenemia, insulin resistance, and the presence of acanthosis nigricans, the diagnosis of hair-an syndrome was made.