scholarly journals Chronic Sheehan’s Syndrome – A Differential to be Considered in Clinical Practice in Women with a History of Postpartum Hemorrhage

Cureus ◽  
2019 ◽  
Author(s):  
Merin Jose ◽  
Saba Amir ◽  
Rajesh Desai
Keyword(s):  
Clinical Practice ◽  
Postpartum Hemorrhage ◽  
Sheehan’S Syndrome ◽  
History Of ◽  
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 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 MON-243 Atypical Presentation of Isolated Adrenocorticotropic Hormone Deficiency and Sheehan’s Syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zahira Marie Lugo López ◽  
Nadyeschka Angelique Rivera Santana ◽  
Andrea del Toro Diez ◽  
Michelle Marie Mangual Garcia ◽  
Ernesto Sola Sanchez ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Adrenocorticotropic Hormone ◽  
Brain Mri ◽  
Pituitary Hormones ◽  
Hormone Deficiency ◽  
Normal Brain ◽  
Sheehan’S Syndrome ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Sheehan's Syndrome

Abstract Introduction: Isolated adrenocorticotropic hormone (ACTH) deficiency is a rare pituitary hormone deficiency defined by secondary adrenal insufficiency and normal secretion of all other pituitary hormones. Patients present with fatigue, weakness, weight loss, anorexia, nausea, low cortisol levels and low ACTH levels. Isolated ACTH deficiency is more common in males and usually presents in the fifth decade of life. Main mechanisms involved in the pathogenesis are genetics and autoimmune causes, traumatic brain injury and infarction of the pituitary postpartum, known as Sheehan’s syndrome. Sheehan’s syndrome is characterized by postpartum hemorrhage, failure to lactate and menstrual irregularities and it can occur from immediate postpartum period to years after delivery. The most common hormone deficiencies are prolactin and growth hormone. Empty sella is the most common finding on brain MRI. We are reporting a case of a woman in her third decade with isolated ACTH deficiency due to Sheehan’s syndrome two years postpartum, able to lactate, with normal menses and normal brain MRI. Clinical Case: A 33-year-old woman G3P3A0 with hypothyroidism who was referred to Endocrinology clinics due to tiredness, fatigue and weakness. She reported postpartum hemorrhage requiring 4 PRBC transfusions and IV steroids after last pregnancy 5 years ago. Patient was able to lactate after pregnancy and continued in her usual state of health until 3 years ago when she referred loss of consciousness with traumatic head injury due to hypoglycemia. At Endocrinology office physical examination and vital signs were unremarkable, including no blood pressure or heart rate variations with positional changes. Despite hypothyroidism being adequately controlled, she continued with extreme fatigue and weakness affecting her quality of life, for which cortisol and ACTH levels were ordered. Laboratories showed normal electrolytes, negative autoantibodies, cortisol 0.20 μg/dL (5-25 μg/dL) and ACTH 22 pg/mL (10-60 pg/mL) suggesting partial isolated ACTH deficiency. ACTH stimulation test was done and noted with suboptimal response. Evaluation of other anterior pituitary hormones was normal. Brain MRI showed normal pituitary gland. She was started on hydrocortisone in AM and PM and symptoms resolved. Conclusion: Immediate recognition of isolated ACTH deficiency due to Sheehan’s syndrome is necessary due to the availability of effective treatment and morbidity and mortality associated with this serious condition. To our knowledge isolated ACTH deficiency due to Sheehan’s syndrome in which the patient was able to lactate and normal findings on brain MRI has not previously been reported.References: Shivaprasad C. Sheehan’s Syndrome: Newer advances. Indian J Endocrinol Metab. 2011 Sep; 15(3): S203-207. DOI:10.4103/2230-8210.84869.

scholarly journals Factor IX Deficiency and Bleeding in a Patient With Sheehan’s Syndrome

Blood ◽  
1972 ◽  
Vol 39 (5) ◽  
pp. 650-657 ◽  
Author(s):  
Clarence H. Brown ◽  
Larry K. Kvols ◽  
Tah-Hsiung Hsu ◽  
Jack Levin
Keyword(s):  
Blood Coagulation ◽  
Coagulation Factor ◽  
Factor Ix ◽  
Endocrine Dysfunction ◽  
Sheehan’S Syndrome ◽  
Adrenal Hormones ◽  
History Of ◽  
Sheehan's Syndrome ◽  
Factor Ix Deficiency ◽  
Normal Hemostasis

Abstract Factor IX deficiency was associated with a hemorrhagic disorder in a woman who previously had experienced postpartum hypotension resulting in Sheehan’s syndrome. There was no family history of Christmas disease, and other known causes of factor IX deficiency were excluded. Plasma levels of factor IX were partially corrected by therapy with thyroid hormones and completely restored to normal by the administration of cortisone. The response of factor IX to plasma infusion resembled the response of factor VIII in patients with von Willebrand’s disease who receive plasma. Normal hemostasis and levels of factor IX have been maintained by the administration of physiologic dosages of thyroid and adrenal hormones. Blood coagulation was studied in several other patients with pituitary or thyroid dysfunction. All were normal, indicating that this patient represents an unusual example of the effects of an endocrine dysfunction on a single blood coagulation factor.

scholarly journals Colonic pseudo-obstruction in a patient with Sheehan’s syndrome

2019 ◽  
Vol 12 (8) ◽  
pp. e228936
Author(s):  
Navneet Kaur ◽  
Ulrich Schubart ◽  
Adel Mandl
Keyword(s):  
Exploratory Laparotomy ◽  
Sigmoid Resection ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Thyroid Function Tests ◽  
Sheehan’S Syndrome ◽  
Central Hypothyroidism ◽  
End Colostomy ◽  
History Of ◽  
Sheehan's Syndrome

A 56-year-old woman with a history of hypothyroidism and chronic constipation presented with an acute abdomen due to colonic pseudo-obstruction. Thyroid function tests were consistent with central hypothyroidism prompting intravenous administration of stress-dose glucocorticoids and levothyroxine. The patient then underwent emergency exploratory laparotomy with sigmoid resection and end-colostomy. The postoperative endocrine evaluation revealed that the patient had panhypopituitarism due to Sheehan’s syndrome (SS). The diagnosis had been missed by physicians who had been treating her for several years for presumed primary hypothyroidism with a low dose of levothyroxine, aimed at normalising a minimally elevated thyroid-stimulating hormone (TSH) level. This is the second reported case of SS presenting with colonic pseudo-obstruction and it illustrates the potential danger of relying on measurement of TSH alone in the evaluation and treatment of thyroid dysfunction.

scholarly journals Adrenal crisis precipitated by influenza A led to the diagnosis of Sheehan's syndrome 18 years after postpartum hemorrhage

2020 ◽  
Vol 8 (12) ◽  
pp. 3082-3087
Author(s):  
Jumpei Taniguchi ◽  
Hitoshi Sugawara ◽  
Hodaka Yamada ◽  
Katsuyuki Yoshida ◽  
Ibuki Kurihara ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Influenza A ◽  
Adrenal Crisis ◽  
Sheehan’S Syndrome ◽  
Sheehan's Syndrome
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