Severe Hyperandrogenemia and Insulin Resistance in a 12-Year-Old Girl

The document described a case of a 12-year-old Vietnamese girl with severe hyperandrogenemia and insulin resistance, symptoms often associated with polycystic ovary syndrome (PCOS). She experienced rapid hyperandrogenism and virilization, with symptoms such as hirsutism, a deepened voice, and oligomenorrhea, and had unusually high testosterone levels exceeding 200 ng/dL. Despite no evidence of ovarian or adrenal masses, her condition was successfully managed with continuous combined oral contraceptives (COCs), which significantly reduced her androgen levels. This case emphasized that PCOS can manifest with higher than expected testosterone levels and that severe hyperinsulinemia may contribute to the rapid progression of hyperandrogenism. The patient's quick and significant response to COCs suggested that PCOS should be considered in similar cases, even when high testosterone levels are not tumor-related.