scholarly journals Sheehan’s syndrome with hypothyroidism: a rare case report

2021 ◽  
Vol 8 (11) ◽  
pp. 1758
Author(s):  
Vignessh Raveekumaran ◽  
Chenthil K. S. ◽  
Vignesh M.
Keyword(s):  
Hormone Replacement ◽  
Delayed Diagnosis ◽  
Sheehan’S Syndrome ◽  
Current Case ◽  
Wide Range ◽  
Rare Case Report ◽  
Acute Gastritis ◽  
Sheehan's Syndrome ◽  
Thyroid Profile ◽  
High Index Of Suspicion

Sheehan's syndrome is a form of hypopituitarism caused by pituitary gland necrosis caused by hemorrhagic shock during pregnancy. It's a rare issue with a wide range of symptoms and a long time to diagnose. A 40-year-old female presented with a giddiness which was rotatory type followed by headache, vomiting associated with nausea, decreased appetite for one week. She has experienced excessive vaginal bleeding and secondary amenorrhea exists for 20 years. Patients diagnosed to have acute liver injury, hyponatremia, and acute gastritis. The thyroid profile showed hypothyroidism and the patient started on appropriate medication. Hypopituitarism due to Sheehan's disease was discovered after a thorough clinical examination, endocrine investigations, and a pituitary magnetic resonance scan. Following the start of hormone replacement therapy, she showed significant improvement. The current case demonstrates that undiagnosed Sheehan's syndrome is linked to long-term morbidity, and we want to emphasize the importance of a high index of suspicion for early diagnosis of the syndrome during routine clinical visits to avoid complications that can arise from delayed diagnosis. 

scholarly journals A 45-year-old female patient with Sheehan’s syndrome presenting with imminent adrenal crisis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Abere Genetu ◽  
Yibeltal Anemen ◽  
Sinshaw Abay ◽  
Simachew Anemen Bante ◽  
Kebadnew Mulatu Mihrete
Keyword(s):  
Case Reports ◽  
Rare Complication ◽  
Hormone Replacement ◽  
Delayed Diagnosis ◽  
Obstetric Care ◽  
Adrenal Crisis ◽  
Sheehan’S Syndrome ◽  
Delay In Diagnosis ◽  
Sheehan's Syndrome

Abstract Background Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis. Case presentation We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Complete clinical evaluation, endocrine studies, and pituitary magnetic resonance scan revealed hypopituitarism secondary to Sheehan’s syndrome. She had significant improvement noted following the commencement of hormone replacement therapy. Conclusion Previous case reports describe patients being diagnosed after one or more complications from long-term panhypopituitarism. The present case illustrates that undiagnosed Sheehan's syndrome is associated with long-term morbidity, and we want to emphasize that a high index of suspicion is crucial for the early diagnosis of the syndrome in routine clinical visits in order to prevent complications arising with delayed diagnosis. Awareness among clinicians is also essential so that such cases are not overlooked, especially in developing nations, where home delivery is still common and obstetric care is limited.

Misleading normal TSH and persistently elevated creatine kinase: clues to the diagnosis of chronic Sheehan’s syndrome

2021 ◽  
Vol 14 (8) ◽  
pp. e243992
Author(s):  
Ayşe Y Demir ◽  
Christine P Oldenburg-Ligtenberg ◽  
Bianca Loredana Toma-Stan ◽  
Albert van de Wiel
Keyword(s):  
Creatine Kinase ◽  
Postpartum Haemorrhage ◽  
Hormone Replacement ◽  
Sella Turcica ◽  
Reference Interval ◽  
Thyroid Stimulating Hormone ◽  
Empty Sella ◽  
Sheehan’S Syndrome ◽  
Elevated Creatine Kinase ◽  
Sheehan's Syndrome

A 53-year-old woman was referred for medical evaluation of therapy-resistant dyslipidaemia accompanied by elevated creatine kinase levels. Because cessation or alteration of her medication did not improve laboratory abnormalities, hypothyroidism was considered, despite the fact that thyroid stimulating hormone levels were within the reference interval. On further evaluation, she was found to have panhypopituitarism and empty sella turcica as shown by MRI. These findings were unexpected since there was no clinical suspicion during detailed evaluation. When supplementary questions were asked, she brought up a history of severe postpartum haemorrhage 30 years ago, for which she underwent a hysterectomy. Based on these findings, the patient was diagnosed with Sheehan’s syndrome. This syndrome is a rare but potentially life-threatening complication of postpartum haemorrhage, characterised by varying degrees of hypopituitarism that are most commonly presented many years after delivery. The patient recovered after adequate hormone replacement therapy.

scholarly journals Delayed diagnosis of Sheehan's syndrome in a developed country: a retrospective cohort study

2013 ◽  
Vol 169 (4) ◽  
pp. 431-438 ◽  
Author(s):  
Cynthia Ramiandrasoa ◽  
Frédéric Castinetti ◽  
Isabelle Raingeard ◽  
Patrick Fenichel ◽  
Olivier Chabre ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
Study Data ◽  
Sheehan’S Syndrome ◽  
Developed Country ◽  
Mean Delay ◽  
Early Signs ◽  
Acute Adrenal Insufficiency ◽  
Sheehan's Syndrome

BackgroundLittle is known about Sheehan's syndrome (SS), even though it is believed that its incidence is low. The aims of this study were to determine the clinical features and diagnostic delay of SS and to ascertain whether early signs could have allowed earlier diagnosis.Subjects and methodsAll patients with SS diagnosed in reference units in the southeast of France between 1980 and 2011 were recruited for this study. Data on obstetrical history, clinical symptoms suggestive of hypopituitarism, early signs, hormone analysis, and magnetic resonance imaging were collected.ResultsOf the 40 women found to have SS, 39 were studied. Mean delay in the diagnosis of SS was 9±9.7 years. We found that four of the 35 assessable patients were diagnosed with agalactia, 16 of the 29 assessable ones with amenorrhea, 19 of the 39 with hypothyroidism, eight with acute adrenal insufficiency, and 15 with asthenia. Among the patients for whom there was a diagnostic delay of more than 1 year (n=28), seven had headaches during the postpartum period, all assessable patients had agalactia, six of the 22 assessable ones had amenorrhea, seven of 28 had hypothyroidism, and 12 of 28 had asthenia.ConclusionMost signs of SS are aspecific and classical signs such as agalactia and amenorrhea are often difficult to detect, which can explain the long diagnostic delay. We suggest that all women failing to lactate after postpartum hemorrhage (PPH) should be evaluated by measuring prolactin levels and women with signs such as amenorrhea and asthenia, even several years after PPH, should undergo a blood test including assessment of thyroxine, TSH, 0800 h ACTH–cortisol, and IGF1 levels.

scholarly journals A rare case report: concurrent COVID-19 and acute cerebrovascular ischemic stroke in a patient with Sheehan’s syndrome

2021 ◽  
Vol 18 (3) ◽  
pp. 58-61
Author(s):  
Deniz Çekiç ◽  
Kubilay Işsever ◽  
Selçuk Yaylacı ◽  
Didar Şenocak ◽  
Sümeyye Çekiç ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Case Report ◽  
Rare Case ◽  
Sheehan’S Syndrome ◽  
Rare Case Report ◽  
Sheehan's Syndrome

scholarly journals Reversible cardiomyopathy as a rare presentation of sheehan’s syndrome-case report and review of literature

2017 ◽  
Vol 4 (6) ◽  
pp. 1713 ◽  
Author(s):  
Mohmmad Hayat Bhat ◽  
Farhana Bagdadi ◽  
Asma Rafi ◽  
Parvaiz Ahmad Shah
Keyword(s):  
Pituitary Gland ◽  
Post Partum ◽  
Hormone Replacement ◽  
Poor Response ◽  
Sheehan’S Syndrome ◽  
Rare Presentation ◽  
Sheehan's Syndrome ◽  
Post Partum Period ◽  
Pressure Changes ◽  
High Degree

Sheehan’s syndrome is a clinical condition characterised by post-partum panhypopitutarism caused by necrosis of the pituitary gland. The hypervascularity of the pituitary gland during pregnancy makes it vulnerable to arterial pressure changes and prone to haemorrhage in the post-partum period. The cardinal features are lethargy, secondary amenorrhea and lactational failure. The diagnosis in immediate post-partum period is difficult and require a high degree of suspicion. Cardiac involvement in sheehan’s syndrome is known but rare.We hereby present a case of post-partum cardiomyopathy with relatively poor response to anti failure treatment. Patient however responded to hormone replacement including glucocorticoids and levothyroxine, after proper confirmation of the hypopituitary state. Cardiac dysfunction markedly reversed with the institution of replacement therapy.

scholarly journals Sheehan’s syndrome: baseline characteristics and effect of 2 years of growth hormone replacement therapy in 91 patients in KIMS – Pfizer International Metabolic Database

2005 ◽  
Vol 152 (4) ◽  
pp. 581-587 ◽  
Author(s):  
Fahrettin Keleştimur ◽  
Peter Jonsson ◽  
Senay Molvalilar ◽  
Jose Manuel Gomez ◽  
Christoph J Auernhammer ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hormone Deficiency ◽  
Sheehan’S Syndrome ◽  
Gh Replacement ◽  
Sheehan's Syndrome ◽  
Baseline Characteristics

Objective: Sheehan’s syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most important causes of hypopituitarism, and hence growth hormone deficiency (GHD), in developing countries. However, little is known about the effects of growth hormone (GH) replacement therapy in patients with Sheehan’s syndrome. Design: The demographic background characteristics of 91 GH-deficient patients with Sheehan’s syndrome (mean age ± s.d., 46.3 ± 9.4 years) were compared with those of a group of 156 GH-deficient women (mean age ± s.d., 51.5 ± 13.1 years) with a non-functional pituitary adenoma (NFPA). The baseline characteristics and the effects of 2 years of GH replacement therapy were also studied in the 91 patients with Sheehan’s syndrome and an age-matched group of 100 women with NFPA (mean age ± s.d. 44.5 ± 10.2 years). Results: All patients were enrolled in KIMS (Pfizer International Metabolic Database). Patients with Sheehan’s syndrome were significantly younger at pituitary disorder onset, diagnosis of GHD and at entry into KIMS than patients with NFPA (P < 0.01), and had significantly lower insulin-like growth factor I levels (P < 0.001). At baseline, quality of life (QoL) was significantly (P < 0.05) reduced in patients with Sheehan’s syndrome compared with those with NFPA (P < 0.001). With regard to treatment effects, lean body mass increased significantly (P < 0.05), QoL improved significantly (P < 0.05) and total and low-density lipoprotein-cholesterol decreased significantly (P < 0.05) in patients with Sheehan’s syndrome after 1 year of GH replacement therapy. Similar significant changes in QoL and lipid profiles occurred in patients with NFPA after 2 years of GH replacement. Blood pressure remained unchanged in patients with Sheehan’s syndrome, but decreased significantly (P < 0.01) in the group with NFPA after 1 year, before returning to pretreatment levels at 2 years. Conclusions: In conclusion, patients with Sheehan’s syndrome have more severe GHD compared with individuals with NFPA. GH replacement therapy in patients with Sheehan’s syndrome may have beneficial effects on QoL, body composition and lipid profile.

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