A decade without diagnosis: Sheehan’s syndrome

Nascimento, Fábio A.; Nery, Juliane; Marques, Gustavo Lenci; Santos, Felipe Dunin dos; Carvalho, Maurício

doi:10.4236/crcm.2013.28128

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…4 In some cases, the diagnosis of Sheehan's syndrome may be delayed for several years until features of hypopituitarism (e.g., secondary hypothyroidism or secondary adrenal insufficiency) become more apparent. 6 The mean period of diagnostic delay is variable and was found to be 20.37 ± 8.34 years on average in one of the retrospective analyses. 7 An undiagnosed woman with Sheehan's syndrome may remain relatively asymptomatic initially, but when exposed to a stressful situation that puts a strain on her thyroid and adrenal glands, symptoms may become evident.…”

Section: Introductionmentioning

confidence: 91%

Sheehan’s syndrome unveiled after decades without a diagnosis: A case report

Rabee’,

Braik,

Alnatour

et al. 2023

SAGE Open Medical Case Reports

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Sheehan’s syndrome is defined as a postpartum infarction of the pituitary gland following hypovolemic shock due to obstetric hemorrhage. Sheehan’s syndrome’s symptoms are often subtle, and hence it is often overlooked. In this report, we discuss a case of an 82-year-old woman who developed severe postpartum hemorrhage after her last childbirth at the age of 37, which required multiple blood transfusions. Since then, she had progressively developed malaise and lastly presented with a new onset of confusion. Basic laboratory tests detected poorly controlled hypothyroidism and severe hyponatremia, which are well-known late-presenting conditions of Sheehan’s syndrome. Escaping the diagnosis for more than four decades is extremely rare and beyond what is reported previously. Despite being a rare cause of hyponatremia in the elderly, physicians should maintain a high index of suspicion and are required to look for a readily treatable and preventable cause of hyponatremia (after excluding the common causes), which may alleviate the suffering of these patients.

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Section: Introductionmentioning

confidence: 91%

Sheehan’s syndrome unveiled after decades without a diagnosis: A case report

Rabee’,

Braik,

Alnatour

et al. 2023

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

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Partial Sheehan’s syndrome with abdominal tuberculosis presented with pancytopenia and fluctuating thyroid profile: a case report

Yadav¹,

Bari

Saha

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Sheehan’s syndrome is a well-recognized cause of panhypopituitarism secondary to pituitary apoplexy, followed by postpartum hemorrhage. Depending upon the degree of ischemic injury, it can be either partial or complete. Case presentation: We report an interesting case of a 35-year-old woman admitted to our hospital with complaints of abdominal distension, which was later presumed to be due to disseminated tuberculosis (TB) after excluding the possible differentials. During the treatment course, she was going through repeated attacks of hypovolemic shock and hypoglycemia due to adrenocortical insufficiency. This, along with the history of prolonged amenorrhea 4 years back due to severe postpartum hemorrhage in her last pregnancy, has led us to our diagnosis of partial Sheehan’s syndrome. After 1 month of starting steroid and anti-TB therapy, it was quite surprising when she presented with features of pancytopenia and antitubercular drug-induced hepatitis. Discussion: Sheehan’s syndrome may have a varying degree of presentation depending upon the degree of damage to the pituitary gland, which includes amenorrhea, lactation failure, adrenocortical insufficiency, hyponatremia, hypoglycemia, as well as pancytopenia in some rare instances The hormone panel especially the thyroid profile should be monitored carefully. Such cases are often challenging to deal with because of their varying degrees of presentation and the delay in diagnosis due to a lack of clinical suspicion. Conclusion: Therefore, we believe that this rare presentation of pancytopenia in Sheehan’s syndrome with fluctuating thyroid profile and abdominal TB in the background will let clinicians approach such a rare disease differently.

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