Analysis of thrombophilic genetic mutations in patients with Sheehan`s syndrome: is thrombophilia responsible for the pathogenesis of Sheehan`s syndrome?

Gökalp, Deniz; Tuzcu, Alpaslan; Bahçeci, Mithat; Ayyıldız, Orhan; Yurt, Murat; Çelik, Yusuf; Alpagat, Gulistan

doi:10.1007/s11102-010-0276-x

Cited by 19 publications

(15 citation statements)

References 29 publications

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“…In a cohort study involving 7405 women in Turkey, the rate of miscarriage was 25% and the rate of stillbirth was 4% during their lifetimes (26). High frequencies of stillbirths and miscarriages in patients with SS may be explained by a disorder such as hypercoagulation (9).…”

Section: Discussionmentioning

confidence: 99%

“…Physiological enlargement of the pituitary gland during pregnancy makes it more vulnerable to ischemic necrosis; however, some other factors have also been suggested to have a contributing role. Thrombosis in the pituitary arteries due to hypercoagulation, arterial vasospasm due to severe hypotension during delivery, pituitary autoimmunity, and smaller sella turcica size have been hypothesized for the etiopathogenesis of the disease (9,10,11,12). Herein, we aimed to investigate the initial clinical and laboratory findings with subsequent course in patients with SS.…”

Section: Introductionmentioning

confidence: 99%

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Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Diri

Tanrıverdi

Karaca

et al. 2014

European Journal of Endocrinology

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Objective: Sheehan's syndrome (SS) is a well-known cause of hypopituitarism resulting from postpartum pituitary necrosis. Because of its rarity in Western society, its diagnosis is often overlooked. We aimed to investigate the clinical, laboratory, and radiological aspects of SS in a large number of patients. Study design: A retrospective assessment of the medical records of 114 patients with SS was conducted. In addition, sella turcica volumes of 29 healthy women were compared with those of patients by magnetic resonance imaging examinations. Results: The mean period of diagnostic delay was 19.7 years in patients with SS. It was found that 52.6% of patients had nonspecific complaints, 30.7% had complaints related to adrenal insufficiency, and 9.6% had complaints related to hypogonadism when diagnosed. At the time of diagnosis, 55.3% of the patients had panhypopituitarism, while 44.7% had partial hypopituitarism. The number of deficient hormones was found to be increased over the years. None of the patients whose basal prolactin was below 4.0 ng/ml had adequate prolactin responses to TRH test, while all patients whose basal prolactin was above 7.8 ng/ml had adequate responses. Mean sella volume was found to be significantly lower in the SS group (340.5G214 mm 3 ) than that in the healthy group (602.5G192 mm 3 ). Conclusions: SS is a common cause of hypopituitarism in underdeveloped and developing countries. The main reasons for diagnostic delay seem to be the high frequency of patients with nonspecific complaints and neglect of SS. In addition, the TRH stimulation test was found to have a high sensitivity and specificity to recognize PRL deficiency. Furthermore, small sella size may have an important contributing role in the etiopathogenesis of SS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Diri

Tanrıverdi

Karaca

et al. 2014

European Journal of Endocrinology

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“…The pathogenesis of this disease involves infarction, secondary to arrested blood flow to the anterior lobe of the pituitary gland [4,5]. Although the specific pathogenesis of SS is not clearly understood, factors such as the enlargement of the pituitary gland, smaller sella turcica, thrombosis, coagulation disorders, and pituitary autoimmunity are considered to be important [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Four decades without diagnosis: Sheehan‘s syndrome, a retrospective analysis

Gökalp

Alpagat

Tuzcu

et al. 2016

Gynecological Endocrinology

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“…Hiperkoagülabilite açısından yapılan tetkiklerinde Tromboza eğilim kalıtsal veya edinsel nedenlere bağlı olarak gelişebilir. Faktör 5 Leiden mutasyonu, protrombin (FII G20210A), MTHFR C677T, A1298C ve PAI-1 4G/5G mutasyonlarının varolduğu hastalarda tromboza eğilim artar (8). Hiperkoagülabilite durumlarında hastalar genel olarak tekrarlayan venöz tromboz riski altındadır.…”

Section: Olgu Sunumuunclassified

A Diagnosis of Total Abdominal Aortic Occlusion in a Patient Who Entered the Emergency Department by Walking

Dündar¹,

Güven²,

Ergin³

et al. 2014

JAEMCR

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Introduction: The risk of thrombosis is increased in hypercoagulability. Hypercoagulability can be inherited or acquired. Here, we want to present a patient with inherited hypercoagulability who came to the emergency department by walking and was diagnosed with total abdominal aortic thrombosis and acute renal artery thrombosis. Case Report: A 48-year-old female patient presented to our emergency medicine department with a history of right flank pain for 30 minutes. The pain had started abruptly and was continuous. She came to the emergency medicine department by walking. The contrast-enhanced abdominal computed tomography showed right renal infarction, right artery occlusion, and abdominal aortic thrombus at the level of the iliac bifurcation. Conclusion: Abdominal aortic thrombus is a relatively rare complication of hypercoagulability. Total occlusion of the aorta is generally presented with pain, pallor, weakness, and numbness of the lower limbs. In our case, there was none of these signs due to the blood flow supplied by collaterals. It is a challenge to diagnose total aortic occlusion in a patient that comes to the emergency department by walking.

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Analysis of thrombophilic genetic mutations in patients with Sheehan`s syndrome: is thrombophilia responsible for the pathogenesis of Sheehan`s syndrome?

Cited by 19 publications

References 29 publications

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Extensive investigation of 114 patients with Sheehan's syndrome: a continuing disorder

Four decades without diagnosis: Sheehan‘s syndrome, a retrospective analysis

A Diagnosis of Total Abdominal Aortic Occlusion in a Patient Who Entered the Emergency Department by Walking

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