A special case of insulin resistance in a 12-year-old girl (Rabson-Mendenhall syndrome)

Abstract

The article presents the results of literature review on Rabson-Mendenhall syndrome and a clinical case of this syndrome in an adolescent girl. The cause of insulin resistance in Rabson-Mendenhall syndrome is a mutation of the insulin receptor gene (INSR). Rabson-Mendenhall syndrome occurs in children of both sexes. The prevalence of the disease is unknown. The genetic risk for descendants is high. Karyotype is normal. Most of the patients have additional features of this syndrome. Symptoms of Rabson-Mendenhall syndrome differ in each case, but it can be suspected already in the first year of life for the lag in weight gain, malformations (coarse facial features, abnormal teeth, hyperpigmentation), abnormally dry skin, hyperglycemia and insulin resistance, as well as additional features (enlarged abdomen, abnormal clitoris, frequent vomiting, ketoacidosis). The diagnosis is confirmed by genetic researches. The present clinical case might be interesting in terms of combination of duodenum ulcer and labile diabetes mellitus, which manifested by frequent episodes of ketoacidosis, and features of INSR mutations.

Keywords

• insulin resistance
• mutations of the insulin receptor gene
• Rabson-Mendenhall syndrome