scholarly journals Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
José Gerardo González-González ◽  
Omar David Borjas-Almaguer ◽  
Alejandro Salcido-Montenegro ◽  
René Rodríguez-Guajardo ◽  
Anasofia Elizondo-Plazas ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Diagnostic Criteria ◽  
Postpartum Hemorrhage ◽  
Hypovolemic Shock ◽  
Sheehan’S Syndrome ◽  
History Of ◽  
Sheehan's Syndrome ◽  
Pituitary Antibodies

Sheehan’s syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed. Twenty women completed the study. Mean age was 26.35 (±5.83) years. The main etiology for severe PPH was uterine atony (65%) which resulted mostly in hypovolemic shock grades III-IV. Within the first four weeks after delivery, 95% of patients had at least one hormonal pituitary affected and 60% of the patients fulfilled diagnostic criteria for hypopituitarism. At the end of the study period, five patients (25%) were diagnosed with hypopituitarism (GH and cortisol axes affected). Anti-pituitary antibodies were negative in all patients. At 6 months follow-up, one in every four women with a history of moderate-to-severe PPH was found with asymptomatic nonautoimmune-mediated hypopituitarism. The role of autoimmunity in Sheehan’s syndrome remains uncertain. Further studies are needed to improve the remaining knowledge gaps.

scholarly journals A case of Sheehan Syndrome with chronic diffuse muscle pain and weakness

2019 ◽  
Vol 6 (11) ◽  
pp. 310-312
Author(s):  
Erhan Önalan ◽  
Şüheda Ataş ◽  
Kübra Oral
Keyword(s):  
Developing Countries ◽  
Postpartum Hemorrhage ◽  
Empty Sella ◽  
Sheehan’S Syndrome ◽  
Laboratory Findings ◽  
Appropriate Treatment ◽  
Pituitary Deficiency ◽  
Sheehan Syndrome ◽  
History Of ◽  
Sheehan's Syndrome

Objective: Sheehan’s syndrome is pituitary deficiency induced by intrapartum and postpartum hemorrhage and hypovolemia. It is still frequent in underdeveloped and developing countries. Sheehan’s syndrome is one of the reason of empty sella. The symptoms of the syndrome can be seen months to years later depend on the degree of pituitary damage. History of postpartum hemorrhage, failure to lactate and cessation of menses are important  clues to the diagnosis. Early diagnosis and appropriate treatment are very important to reduce morbidity  and mortality of the patients. Case: In this study sheehan’s syndrome which led to auto pan-hypopituitarism and developed gradually in a patient with sheehan‘s syndrome  which in this case, delivered a baby at home 27 years ago and had severe postpartum hemorrhage will be presented. And this 63-year-old female patient was diagnosed as Sjogren’s syndrome and sheehan syndrome by clinical and laboratory findings for the purpose of further investigation and treatment because of symptoms of fever and anemia

scholarly journals A Case Report on Sheehan's Syndrome

2013 ◽  
Vol 3 (2) ◽  
pp. 49-50
Author(s):  
S Pokharel ◽  
SC Jha ◽  
D Maskey ◽  
B Shrestha ◽  
P Poudel ◽  
...  
Keyword(s):  
Case Report ◽  
Postpartum Hemorrhage ◽  
Pituitary Apoplexy ◽  
Bleeding Episode ◽  
Hypovolemic Shock ◽  
Massive Hemorrhage ◽  
Sheehan’S Syndrome ◽  
Medical College ◽  
Postpartum Bleeding ◽  
Sheehan's Syndrome

Sheehan’s syndrome is a well-known cause of panhypopituitarism secondary to pituitary apoplexy, that generally occurs after an intra- or postpartum bleeding episode characterized by massive hemorrhage and hypovolemic shock. The diagnosis can be difficult and is often formulated after some years from the syndrome occurrence. We report the case of a woman with a relatively early diagnosed Sheehan’s syndrome associated with amenorrhoea and secondary hypothyriodism complicated by postpartum hemorrhage. DOI: http://dx.doi.org/10.3126/jcmc.v3i2.8444 Journal of Chitwan Medical College Vol.3(2) 2013 49-50

Young Male with Bilateral ICA Dissection: Beyond CADISS Trial

2021 ◽  
pp. 251660852098428
Author(s):  
Vikas Bhatia ◽  
Chirag Jain ◽  
Sucharita Ray ◽  
jay Kumar
Keyword(s):  
Management Strategies ◽  
Young Male ◽  
Acute Onset ◽  
The Body ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Stroke Study ◽  
History Of

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.

scholarly journals Associação entre a sintomatologia dolorosa e a disfunção temporomandibular

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Wyllka Cyntya Galvão da Silva ◽  
Karolinne Domingos Medeiros ◽  
Eloisa Cesário Fernandes ◽  
Sandja Gabriela Oliveira ◽  
Caio Rodrigues Maia ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Temporomandibular Disorders ◽  
Temporomandibular Disorder ◽  
Epidemiologic Study ◽  
Masticatory Muscles ◽  
Degenerative Disorders ◽  
International Conference On Bioinformatics ◽  
Research Diagnostic Criteria

Introdução: A Disfunção Temporomandibular (DTM) é um quadro patológico que afeta o sistema estomatognático e, frequentemente, acompanhada de dor. Objetivos: Aferir o nível de dor dos pacientes portadores de DTM e a prevalência de sintomatologia articular e muscular. Percebeu-se que a relação entre a origem da DTM e a sintomatologia dolorosa é pouco relatada na literatura. Materiais e Métodos: Trata-se de um estudo descritivo, observacional de corte transversal, desenvolvido com 30 pacientes com DTM, diagnosticado pelo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A amostra foi determinada pelas estimativas de atendimento. A associação entre a sintomatologia e a origem da DTM foram verificadas através do teste qui-quadrado, com intervalos de confiança (95%). Foi usada uma ficha clínica para a coleta de dados com idade, gênero e nível da dor, que foi aferido através da Escala Visual Analógica de dor. Resultados: Constatou-se que 26 pacientes eram do sexo feminino e 4 do sexo masculino. Quinze apresentaram idade inferior a 36,5 anos, e os outros uma idade superior a esta. Quanto a origem da DTM, 19 tinham desordem articular e 11 muscular. A categoria moderada foi o nível mais prevalente, seguida do intenso. Determinou-se que não houve associação estatisticamente significante entre as variáveis deste estudo com a DTM. Conclusão: Constatou-se que, os fatores etiológicos analisados isoladamente não influenciam de forma única no desenvolvimento da DTM, mas poderão atuar em conjunto com outros fatores, já que a sua causa é multifatorial.Descritores: Dimensão Vertical; Boca Edêntula; Dor Facial; Síndrome da Disfunção da Articulação Temporomandibular.ReferênciasDworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55.Gonçalves DAG, Bigal ME, Jales LCF, Camparis CM, Speciali JG. Headache and symptoms of temporomandibular disorders: an epidemiologic study. Headache. 2010;50(2):231-41.Piccin CF, Pozzebon D, Chiodelli L, Boufleus J, Pasinato F, Corrêa ECR. Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular. Revista Cefac. 2016;18(1):113-19.Winocur E, Emodi-Perlman A. Occlusion, orthodontic treatment and temporomandibular disorders: myths and scientific evidences. in: Orthodonthics-basis aspects and clinical considerations. In Tech. 2012.Jorge JMS, Dini C, Santos L, Camara de Bem SH, Custodio W. Associação entre dimensão vertical de oclusão e transtornos temporomandibulares. ClipeOdonto – UNITAU. 2016;8(1):44- 50.Bayma PTC, Feltrin PP, Dias CAS, Costa JF, Laganá DC, Inoue RT. Temporomandibular disorders in otolaryngology patients. RGO (Porto Alegre). 2010;58(3):313-17.Martinez JE, Grassi DC, Marques LG. Análise da aplicabilidade de três instrumentos de avaliação de dor em distintas unidades de atendimento: ambulatório, enfermaria e urgência. Rev Bras Reumatol. 2011;51(4):299-308.Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dental Res. 2016; 95(10):1084-92.Rauhala K., Oikarinen KS, Raustia AM. Role of temporomandibular disorders (TMD) in facial pain: occlusion, muscle and TMJ pain. Cranio. 1999;17(4):254-61.Manfredini D, Favero L, Gregorini G, Cocilovo F, Guarda-Nardini L. Natural course of temporomandibular disorders with low painrelated impairment: a 2-to-3-year follow-up study. J Oral Rehabil. 2013;40(6):436-42.Freitas LS. Associação da disfunção Temporomandibular com o polimorfismo 102T-C do gene receptor da serotonina HTR2A [tese]. São José do Rio Preto: Faculdade de Medicina do São José do Rio Preto – FAMERP; 2011.Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307.Lopes PRR, Campos PSF, Nascimento RJM. Dor e inflamação nas disfunções temporomandibulares: revisão de literatura dos últimos quatro anos. R Ci med biol. 2011;10(3):317-25.Wang X, Guo H, Wang Y, Yi X. The effects of estrogen on cytoplasmic ca2+ concentration of masticatory muscles myoblast in acid condition. 5th International Conference on Bioinformatics and Biomedical Engineering (iCBBE); 10-12 May 2011; Wuhan, China. Anais. Disponível em http://www.icbbe.org/2011/Proceeding2010.aspx.Cairns BE. Pathophysiology of TMD Pain—Basic Mechanisms and Their Implications for pharmacotherapy. J Oral Rehabil. 2010; 37(6):391-410.Portinho CP, Razera MV, Splitt BI, Gorgen ARH, Faller GJ, Collares MVM. Apresentação clínica inicial em pacientes com disfunção Temporomandibular. Rev Bras Cir Craniomaxilofac. 2012;15(3):109-12.

scholarly journals Radiotherapy for Recurrent Keloid: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 89-91
Author(s):  
Christina Hari Nawangsih Prihharsanti ◽  
Muhamad Rizqi Setyarto ◽  
Dion Firli Bramantyo
Keyword(s):  
Connective Tissue ◽  
Recurrence Rate ◽  
Corticosteroid Injection ◽  
Inflammatory Cells ◽  
Early Postoperative Period ◽  
High Recurrence Rate ◽  
Surrounding Soft Tissue ◽  
History Of

Background: Keloid is a benign growth of connective tissue. There are several risk factors that play a role in keloid growth. Excision surgery is one of the modalities in the treatment of keloids. However, excision surgery alone has a recurrence rate of 45-100%.Case: Male, 37 years old, with complaints arising from a keloid lesions in the left earlobe since three years ago with a history of previous injuries. The lesions is then operated on but always grows back postoperatively. The number of surgeries that have been carried out three times with further treatment in the form of corticosteroid injection. However, keloid still recurrence. Finally it was decided to undergo treatment with surgery followed by radiotherapy within a period of no more than 24 hours postoperatively. Follow-up after six months gave good results without recurrence.Discussion: Keloid has a high recurrence rate after excision surgery. Surgery followed by radiotherapy has a low recurrence rate compared to surgery or surgery followed by administration of corticosteroid injections. Radiotherapy as adjuvant therapy for postoperative keloid excision has the role of sterilizing the connective tissue stem cell active fibroblasts and acute inflammatory cells that grow in the early postoperative period. A study states that administration of postoperative radiation with electrons in keloids in the earlobe at a dose of 15 Gy in three fractions gives a low recurrence rate and a low risk of side effects in the surrounding soft tissue. 

scholarly journals Acute Sheehan’s Syndrome Associated with Postpartum Hemorrhage

2017 ◽  
Vol 23 (1) ◽  
pp. 65-67
Author(s):  
Deokkyeong Kim ◽  
Jiwon Min ◽  
Yun-Sook Kim ◽  
Aeli Ryu
Keyword(s):  
Postpartum Hemorrhage ◽  
Sheehan’S Syndrome ◽  
Sheehan's Syndrome

Recurrent hypoglycaemia and dilated cardiomyopathy: delayed presentation of Sheehan’s syndrome

2021 ◽  
Vol 14 (6) ◽  
pp. e242747
Author(s):  
Archita Makharia ◽  
Manoj Lakhotia ◽  
Vineet Tiwari ◽  
Kishan Gopal
Keyword(s):  
Dilated Cardiomyopathy ◽  
Clinical Manifestations ◽  
Diabetic Woman ◽  
Delayed Presentation ◽  
Sheehan’S Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Sheehan's Syndrome ◽  
Ischaemic Necrosis ◽  
Recurrent Hypoglycaemia

Sheehan’s syndrome (SS) is ischaemic necrosis of the pituitary gland due to massive postpartum haemorrhage. The clinical manifestations may vary from subtle to life-threatening and may present immediately after delivery or many years later. We present a case history of a 58-year-old non-diabetic woman who had undetected SS and presented with two unusual manifestations, including recurrent hypoglycaemia and dilated cardiomyopathy 34 years after delivery. The dilated cardiomyopathy reversed partially after treatment.

THE ROLE OF SECRETING FUNCTION OF DECIDUA IN THE DEVELOPMENT OF COMPLICATIONS OF GESTATION PROCESS IN PREGNANT WOMEN WITH A PAST HISTORY OF CHRONIC ENDOMETRITIS

2020 ◽  
Vol 73 (11) ◽  
pp. 2416-2420
Author(s):  
Olena О. Taranovska ◽  
Volodymyr К. Likhachov ◽  
Ludmyla М. Dobrovolska ◽  
Oleg G. Makarov ◽  
Yanina V. Shymanska
Keyword(s):  
Pregnant Women ◽  
Past History ◽  
Control Group ◽  
Predisposing Factor ◽  
Chronic Endometritis ◽  
The Past ◽  
Early Stages ◽  
History Of ◽  
In The Beginning

The aim: To determine the serum FAMG in the I and II trimester of pregnancy in women with a past history of chronic endometritis, and to clarify its impact on the development of pathology of pregnancy. Materials and methods: The level of FAMG was determined at 6-8 and 16-18 weeks of gestation in 135 pregnant women with a past history of chronic endometritis, who received treatment of chronic endometritis at the stage of pregravid preparation and 168 women who became pregnant without its prior treatment. The dependence of the development of pre-eclampsia on the level of FAMG at the early stages of pregnancy has been evaluated. Results: At 6-8 weeks of pregnancy, the level of FAMG in women with a past history of chronic endometritis was 20.6% lower (122.4 ± 7.6 ng/ml) compared to the control group. In FAMG of 90.3 ± 4.3 ng/ml at 6-8 weeks of gestation, spontaneous abortion occurred in 100% of cases within the next 2 weeks. FAMG lower than 122,1 ± 3,0 ng/ml can be the predisposing factor for the development of pre-eclampsia. Conclusions: Reduced FAMG in the beginning of pregnancy in women with untreated chronic endometritis in the past history increases the incidence of miscarriages at the early stages by 2.6 times, and by 1.8 times the probability of preeclampsia development. Treatment of chronic endometritis at the stage of pregravid preparation promotes the increase of FAMG by 24,6% compared to untreated women that reduces the probability of complications during the subsequent course of pregnancy.

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