A case of Sheehan syndrome six years postpartum with hypothyroidism and mild hyponatremia

Abstract

Sheehan syndrome, also referred to as postpartum hypopituitarism is often a sequela of massive post-partum hemorrhage in resource poor healthcare settings where blood loss during delivery is often neglected. The diagnosis of this rare but fatal is disease is often delayed because the symptoms are vague and the pituitary dysfunction is insidious in nature. This condition sometimes takes more than a decade before it is diagnosed. The classic signs and symptoms include agalactia, secondary amenorrhea and dry wrinkling skin. Often an empty or a partially empty sella is seen on magnetic resonance imaging of the brain. We present the case of a 35-year-old multiparous female with anhedonia and raised serum transaminases who presented to our side with mild hyponatremia and hypothyroidism. She got diagnosed with Sheehan syndrome at our set up six years after her last obstetric event. Through this case report, we intend to provide a clinical account of the patient’s condition and management.