58ESPE P3-130 Maria Krajewska Fat, metabolism andobesity Table 1. Patient 1 ▪ Patient Photo 1. • • Acanthosis ( Insulin (mg/dl) Glucose OGTT Literature uIU A 13 Treatment Diagnosis • • Additional Control • Intervention • • • • L • • • • • Physical • • • Medical /ml) aboratory We Acanthosis monogenic Anti Elevated Dietary max 106 mg%, Glycemia HbA1c= 6% (norm 4,5 OGTT and IGF1, HDL 42 (norm > 45 mg/dl), no Normal Secondary Steatomastia pink (Photo 1) behind the ears, in the acanthosis nigricans on the neck, elbows pc, Obesity negative family history: grandfather suffers from type 2 diabetes and hypertension acanthosis nigricans 4 frequent and irregular eating excessive body weight from of weight 3100g, length 51 cm, born nigricans - year - : would Patient 5 liters per day), insufficient physical activity Inbal chronic due - GAD, anti stretch stretch marks around the abdominal 1 298 104 0’ laboratory history from - - examination old boy hyperglycaemia : : Sander, Jeffrey : management, function body blood like BMI 32 metformin diabetes tests C 1 : nigricans profile: history low and - - uncomplicated uncomplicated pregnancy with the forces of nature sex sex diseases diabetes peptide acanthosis - to : weight and OGTT, HOMA IR= 76,52, QUICKI= 0,22 - concentration : nigricans obesity IA referred present tests characteristics after , of 6 kg/m2 472 206 30’ tests - before of 2 and ICA gynecomastia mellitus thyroid , is 9,44 (norm 1,06 : familial behavioral Callen : 60kg 60kg meals ( and results well . was was increased - nigricans axillae 6,2%) after the to the Clinic and and 2 (>97 (>97 taking , , ( Abena known type noticed - liver +/ history acanthosis 1110 232 60’ within extremely within weight of remain - , the , in 10% other pc inTanner genital large amounts of sweets and sweet drinks (up to hours vitamin therapy 2 and medications O infancy physical ) age as as the skin symptom of insulin Ofori (height (height 170cm= 85 pc, of the norm at ) the , fat percentage 38%) - kidneys lipid by in the loss 3,53 after two the of five: region, : 1135 247 90’ normal high Acanthosis : diet, nigricans D= D= 8,9 dermatologist scale fed with modified milk disorders age , young region activity ng 3,5 kg meals knees study hyperinsulinemia , /ml) hypercortisolemia regular : G III, PIII of 12 in values ng ; guinal ) patients nigricans Maria Maria Krajewska, Jędrzej Nowaczyk, Dominika Labochka, ( and (for 6 and /ml Table , Acanthosis nigricansasapresentation ofsevereinsulin 1489 233 120’ years normal physical , obesity knuckles due and Department of Paediatrics and Endocrinology, and Paediatrics of Department Warsaw,of University Medical Poland genetic days 3) . UpToDate . with weight to abdominal : ) morphology - acanthosis severe ( activity fasting , , 1419 224 150’ tests Table of the negative 38 was was resistance 94 , 15.03.2018 , weeks , for 3 kg= excluded 1) acanthosis glucose han skin skin folds , history ions , ds 1561 203 180’ , body >97 >97 , , nevertheless , nigricans resistance inobesechildren • Laboratory • • • 10% • Physical familial • insufficient physical activity frequent and irregular eating • medications psychomotor • Medical A 14 Treatment Diagnosis Control • Intervention • • other ( Insulin (mg/dl) Glucose OGTT Table Patient Patient as as systematic reduction of skin symptoms. This fact shows, that in obese children severe resistance insulin as well In short time after weight loss in both patients observed we improvement in HOMA Patient 2 has the diagnosis of obesity and severe resistance. insulin In our first patient diagnosed we diabetes mellitus type 2. sarcoma or gastric adenocarcinoma). (connected with mutations in FGFR3) and some It strongly suggests resistance. insulin But it should also be diagnosed familial in acanthosis nigricans Acanthosis nigricans should always be considered as a symptom of systemic abnormalities. Conclusions: Photo 2. Table uIU Normal Secondary Steatomasti acanthosis nigricans on the neck, obesity BMI 32 family history: grand excessive body weight from born with the forces of nature, Dietary HbA1c= 5,5% (norm 4,5 OGTT DOI: 10.3252/pso.eu.58ESPE.2019 children Patient combined acantosis /ml) ) - , fat percentage 38 year lipid 2. 3. - 2 1 acanthosis normal management, laboratory function history Laboratory Patient with - examination - Patient disorders old boy : : with insulin diet, obesity sex sex tests a 2 : a casereport nigricans nigricans can be reversible after the diet and behavioral therapy. development 300 84 0’ such ,8 glycemia characteristics : 2 regular of - : 2 kg/m2 referred acanthosis nigricans , - skin skin thyroid , tests tests severe OGTT, HOMA IR= 62,22, QUICKI= 0,23 normal mother : increased resistance ,7 disorders physical - (>97 (>97 and and HOMAindex 6,2%) %) after , to the since 620 120 30’ liver insulin insulin : QUICKI 0,23 HOMA Insulin300 Glucose QUICKI 0,22 HOMA Insulin298 Glucose Before suffers from type 2 and morphology the nigricans extremely pc from in Tanner weight and ) early the Clinic obesity physical activity (height (height usually of major - - in the skin resistance IR 62,22 IR 76,52 weight uncomplicated uncomplicated pregnancy 84 mg/dl 104 mg/dl infancy kidneys childhood uIU uIU by loss high , , 971 129 60’ scale 168,5 metformin - undergo /ml /ml ions activity general loss before grade Poster Poster period. period. , 7,3 kg/1,5 hyperinsulinemia folds - hypercortisolemia : G IV, P V and IGF1, cm= diabete : malignan . Anna Kucharska, Anna Kucharska, Beata Pyrżak and , the pediatrician a - 50 Negative long presented discontinued after 875 110 90’ pc, s, upper month QUICKI 0,3 HOMA Insulin28,6 Glucose QUICKI 0,29 HOMA Insulin42,4 Glucose After low way brother t weight weight states concentration history chest weight , 40 until due - - ( ( IR 5,16 IR 7,43 Table Table was was 73 mg/dl 71 mg/dl is at: (for example 9 loss due weeks they to , 3,3 uIU uIU suffering arms 738 100 120’ excluded loss of 2) acanthosis 3) to /ml /ml kg= chronic are , with b digestive , axillae of properly >97 >97 pc, from , HDL 35 (norm > 45 mg/dl), no vitamin Wilm’s diseases ody nigricans and autism 400 78 150’ - tract IR and QUICKI followed by due weight weight acanthosis reduction Clinically ∆ = BMI - acanthosis reduction Clinically ∆ = BMI - Degree diagnosed 7,3 kg/ 1,5 3,5 kg/ 7 D= D= 7,1 genital tumor, osteogenic problems body , and negative and 27 of - - : : 2,5 / 1,5 1,2 / 7 of the of the ng taking region region (Photo 2) systematic systematic 00g days weight weight nigricans nigricans obesity . month /ml 249 47 180’ . Delayed severity severity days history month 54 reduction . kg kg of of of ( +/ -