Achard-Thiers syndrome in post-menopausal women: The hidden complexity

ATS, a rare disorder primarily affecting postmenopausal women, is characterized by the coexistence of DM Type 2 and elevated androgen levels. Despite its rarity, the syndrome poses diagnostic challenges due to its masked presentation under the guise of DM Type 2 and cosmetologic uses.
This study presents two unique cases of ATS, each with distinct onset scenarios, one following pregnancy and the other post-surgical transfusion. Both cases exhibit common symptoms of hirsutism and clitoromegaly, further emphasizing the importance of prompt and accurate diagnosis.
Laboratory, imaging, and clinical assessments play pivotal roles in identifying ATS amidst overlapping symptoms. Treatment options include hormone replacement therapy, antiandrogen therapy, glucose management, and cosmetic procedures. These cases show how important it is to have high clinical suspicion and a full evaluation to make sure that ATS is quickly identified and effectively treated in postmenopausal women who also have DM Type 2.