scholarly journals Co-presentation of Acute Sheehan Syndrome with Raised Intracranial Pressure in a Post-partum Lady

2021 ◽  
pp. 1-3
Author(s):  
Richmond Ronald Gomes ◽  
Keyword(s):  
Intracranial Hypertension ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Tissue Destruction ◽  
Sheehan’S Syndrome ◽  
Sheehan Syndrome ◽  
Optic Disc Swelling ◽  
Sheehan's Syndrome

Sheehan’s syndrome (SS) or necrosis of pituitary gland is a rare complication of severe postpartum hemorrhage. It may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. Sheehan’s syndrome though rare is still one of the commonest causes of hypopituitarism in developing countries like ours. The presence of an intercurrent infection and administration of thyroxine exacerbated her corticosteroid insufficiency. Intracranial hypertension (IH) manifested as bilateral optic disc swelling with reduced visual acuity, bilateral sixth nerve palsies, and impaired consciousness. Intracranial hypertension (IH) has been associated with hypocortisolism caused by either primary adrenocortical insufficiency or corticosteroid withdrawal. The author describes a case of a young lady with IH with acute SS who presented on 3rd day postpartum after lower uterine cesarean section with acute severe symptomatic hyponatremia which was complicated by postpartum hemorrhage. The clinical manifestations of IH resolved with corticosteroid replacement

scholarly journals Diagnosis Delayed but not Denied - Sheehan’s syndrome

2015 ◽  
Vol 53 (197) ◽  
pp. 31-33 ◽  
Author(s):  
Vijayeshree Thyagaraj ◽  
MJ Vinod Kumar
Keyword(s):  
Developing Countries ◽  
Renal Failure ◽  
Postpartum Hemorrhage ◽  
Rare Complication ◽  
Obstetric Care ◽  
Sheehan’S Syndrome ◽  
Sheehan Syndrome ◽  
Life Threatening ◽  
Sheehan's Syndrome ◽  
High Index Of Suspicion

Sheehan’s syndrome is a rare complication of postpartum hemorrhage. With advancement in obstetric care, Sheehan's syndrome has become uncommon except in developing countries. Here, we report a patient with Sheehan’s syndrome who escaped diagnosis for 22 years and presented with life threatening complications. This patient also had certain unusual features of Sheehan’s syndrome like pancytopenia and renal failure. A high index of suspicion is necessary in diagnosing such patients.  Keywords: pancytopenia; renal failure; Sheehan syndrome.  

scholarly journals The Symptoms Get Worse after Pregnancy in Sheehan's Syndrome: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Jingwen Hao ◽  
Min Liu ◽  
Zhaohui Mo
Keyword(s):  
Postpartum Hemorrhage ◽  
Unusual Case ◽  
Clinical Manifestations ◽  
Good Prognosis ◽  
Resonance Imaging ◽  
Tissue Destruction ◽  
Sheehan’S Syndrome ◽  
The Third ◽  
Spontaneous Pregnancy ◽  
Sheehan's Syndrome

Sheehan’s syndrome, which is pituitary necrosis after severe postpartum hemorrhage and hypovolemia, may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. We report an unusual case, in which a 55-year-old woman with Sheehan's syndrome got worse symptoms after spontaneous labor. In 1998, she had severe postpartum hemorrhage and pituitary necrosis during the third delivery, thus it was diagnosed as Sheehan’s syndrome by clinical manifestations, laboratory tests, and magnetic resonance imaging. She was treated by replacement therapy including hydrocortisone and levothyroxine sodium. However, she had the fourth spontaneous pregnancy in 2000 and got worse symptoms after delivery. We carefully concluded that pregnancy provided no evidence against the diagnosis of Sheehan’s syndrome because pregnancy might improve hypopituitarism by stimulating the pituitary remnant to undergo hyperplasia and irritating the placenta to secrete hormone. However, pregnancy might aggravate the symptoms by inducing autoimmunity as well. All in all, early diagnosis and adequate medical treatment are important to provide a good prognosis of Sheehan’s syndrome.

scholarly journals Sheehan's Syndrome Presenting with Hyponatraemia: A Case Report

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Prasanta Kumar Bhattacharya MBBS MD PhD FICP FACP ◽  
Aakash Roy MBBS ◽  
Md. Jamil MBBS MD ◽  
Pranjal Phukan MBBS MD DM ◽  
Kalyan Sarma MBBS
Keyword(s):  
Late Onset ◽  
Post Partum ◽  
Rare Complication ◽  
Pituitary Hormones ◽  
Sheehan’S Syndrome ◽  
Secondary Amenorrhea ◽  
Sheehan Syndrome ◽  
Sheehan's Syndrome ◽  
Psychiatric Manifestations ◽  
Lactational Failure

Sheehan syndrome (SS), or post partum necrosis of the pituitary gland, is a rare complication of post partum haemorrhage usually presenting with failure of lactation and subsequent amenorrhoea. We report a case of a 30-year-old woman with history of secondary amenorrhea and lactational failure following childbirth complicated with severe post partum hemorrhage, who presented to us with anemia, hypotension, acute confusion, neuropsychiatric manifestations, abnormal posturing and severe hyponatraemia. Hormonal assays revealed low pituitary hormones, subnormal levels of cortisol and thyroid hormones, with magnetic resonance imaging of the brain suggestive of SS. Hyponatraemia and late onset neuro-psychiatric manifestations are uncommon presentations of SS. Hence, there should be a high index of clinical suspicion for Sheehan’s syndrome in women with secondary amenorrhea and lactational failure following childbirth, who present with late onset neuro-psychiatric manifestations and hyponatremia.

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 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.

scholarly journals A Case of Sheehan's Syndrome Associated with Severe Anemia and Empty Sella Proved 48 Years After Postpartum Hemorrhage.

1995 ◽  
Vol 42 (6) ◽  
pp. 803-809 ◽  
Author(s):  
KIMIKO ISHIKAWA ◽  
MOTOI SOHMIYA ◽  
HIROSHI FURUYA ◽  
YUZURU KATO
Keyword(s):  
Postpartum Hemorrhage ◽  
Empty Sella ◽  
Severe Anemia ◽  
Sheehan’S Syndrome ◽  
Sheehan's Syndrome

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 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.

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