Definition:
Rabson-Mendenhall syndrome is characterized by severe resistance to insulin, abnormal growth and development, acanthosis nigricans, and, in some cases, a hypertrophic pineal gland. In this rare insulin receptor disorder, the patient's body suffers from a disability to use insulin which is needed to control blood sugar levels.
Treatment:
Treating Rabson-Mendenhall syndrome with pharmacologic human leptin may improve the condition of the fasting hyperglycemia, hyperinsulinemia, basal glucose, and glucose and insulin tolerance.
Symptoms and Signs:
In the very few documented cases of this extremely rare disease, young patients demonstrated skin abnormalities, dental deformities, abdominal distention, and phallic enlargement. Inflicted children were described to have coarse, senile-like faces, striking hirsutism, and early dentition. Prognathism, very thick fingernails, and acanthosis nigricans were also noted.
In the case of one girl, an adult hair growth was seen at 5 years of age. Another inflicted girl was observed to have enlarged genitalia at only 6 months old, large enough to allow vaginal examination for diagnosis of a left ovarian tumor. In all these cases, the inflicted children were mentally precocious.
Insulin-resistant diabetes developed in these recorded cases, resulting in the deaths of the patients during childhood due to infections.
Causes:
Rabson-Mendenhall syndrome is a rare hereditary symptom transmitted via autosomal recessive pattern of inheritance. The condition often affects the children of consanguineous parents.
Similar to leprechaunism, Rabson-Mendenhall syndrome results from a molecular mutation of both alleles of the insulin-receptor gene.
Biologically, infants present with fasting hypoglycemia, postprandial hyperglycemia and hyperinsulinemia. The latter often progresses to permanent hyperglycemia and recurrent diabetic ketoacidosis.
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