Sheehan syndrome: Cardiovascular and metabolic comorbidities

Abstract

Sheehan syndrome (SS) caused by postpartum hemorrhage leads to partial or complete pituitary hormone deficiency. In addition to lipid and glucose abnormalities, patients with SS have increased body fat, insulin resistance (IR), coagulation abnormalities, increased leptin concentration, low-grade inflammation, and endothelial dysfunction that predispose them to cardiovascular diseases. Untreated growth hormone (GH) deficiency, hypogonadism, and excess glucocorticoid use are considered risk factors for these abnormalities. Compared to other hypopituitary subjects, patients with SS are younger and have a longer duration of disease and severe GH deficiency. Replacement with GH in addition to standard hormone replacement improves their cardiometabolic profile.

Decompensated Heart Failure Secondary to Hypopituitarism in an Elderly Patient

“…Moreover, hypopituitarism can be fatal owing to a decrease in the hor-mone levels if the disease is not properly diagnosed or treated. In particular, a previous study revealed that hypopituitarism may also deteriorate the condition of concomitant disorders (5). Therefore, an appropriate diagnosis and management of hypopituitarism are important.…”

Postpartum acute adrenal insufficiency of early‐onset Sheehan syndrome: A case series study in a single center

“…Excessive growth hormone replacement negatively affects glucose tolerance, suggesting a potential risk for metabolic syndrome and diabetes. 5 Patients with pituitary insufficiency have a high incidence of cardiovascular events. 21 A report on the assessment of the risk of cardiovascular events in Sheehan syndrome using coronary artery calcification revealed that the Sheehan syndrome group had significantly more coronary artery calcification than the control group.…”

“…Growth hormones also have insulin‐antagonistic effects. Excessive growth hormone replacement negatively affects glucose tolerance, suggesting a potential risk for metabolic syndrome and diabetes 5 . Patients with pituitary insufficiency have a high incidence of cardiovascular events 21 .…”

“…One of the sequelae is Sheehan syndrome, defined as pan pituitary insufficiency caused by a broad area of infarction or necrosis in the pituitary gland in postpartum women. 5 Sheehan syndrome can be classified into earlyand late-onset types, with the latter being more common than the former. Chronic or late-onset Sheehan syndrome is often detected years or decades postpartum, and affected women may present various symptoms, including lactation disorders, menstrual irregularities, fatigue, headaches, and hypotension, depending on the hormone secreted in reduced amounts due to hypopituitarism.…”

“…Women who experienced postpartum hemorrhage may experience sequelae several years after giving birth. One of the sequelae is Sheehan syndrome, defined as pan pituitary insufficiency caused by a broad area of infarction or necrosis in the pituitary gland in postpartum women 5 . Sheehan syndrome can be classified into early‐ and late‐onset types, with the latter being more common than the former.…”