Abstract
Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis. We describe the case of a 45-year-old Ethiopian woman who presented with generalized fatigue for 18 years which progressed to anorexia, nausea, vomiting, diarrhea, and abdominal pain of 6 years' duration, for which she was treated symptomatically throughout these years. Complete clinical evaluation, endocrine studies, and pituitary magnetic resonance scan revealed hypopituitarism secondary to Sheehan's syndrome. She had significant improvement noted following the commencement of hormone replacement therapy. Previous case reports describe patients being diagnosed after one or more complications from long-term panhypopituitarism. The present case illustrates that undiagnosed Sheehan's syndrome is associated with long-term morbidity, and we want to emphasize that a high index of suspicion is crucial for the early diagnosis of the syndrome in routine clinical visits in order to prevent complications arising with delayed diagnosis. Awareness among clinicians is also essential so that such cases are not overlooked, especiall...Continue Reading
References
Oct 15, 1978·American Journal of Obstetrics and Gynecology·G DiZeregaD R Mishell
Oct 1, 1987·British Journal of Obstetrics and Gynaecology·A A LakhdarP C Rubin
Feb 1, 1993·Australian and New Zealand Journal of Medicine·R J DashS Suri
Jul 22, 1998·Lancet·S W LambertsA J van der Lely
Mar 16, 2000·Drugs·J J Orrego, A L Barkan
Mar 16, 2000·Clinical Endocrinology·J S DaviesM F Scanlon
Jun 3, 2000·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Y Y HuangJ S Tsai
Feb 14, 2003·Lancet·Kalman Kovacs
Aug 28, 2003·Endocrine Journal·Murat SertMustafa Kocak
Apr 6, 2004·Annals of Hematology·Dae-Young KimByoung Kook Kim
Jul 9, 2004·Pituitary·Fahrettin Keleştimur
Jul 24, 2004·BMJ : British Medical Journal·Joseph Abbott, Graham R Kirkby
Jun 21, 2006·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Hatice Sebila DökmetaşOzlem Yonem
Nov 4, 2010·Clinical Endocrinology·Senthil RajasekaranJohn Wass
Oct 27, 2011·Indian Journal of Endocrinology and Metabolism·C Shivaprasad
Aug 16, 2013·The Journal of Obstetrics and Gynaecology Research·Takahiro MatsuwakiHideaki Masuzaki
Jan 8, 2014·European Journal of Endocrinology·R A AlwaniR A Feelders
May 21, 2014·BMJ Case Reports·Naresh KumarDinesh Kumar Dhanwal
Jun 3, 2016·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Deniz GokalpAzad Yildirim
Dec 23, 2016·Nature Reviews. Disease Primers·Züleyha KaracaFahrettin Kelestimur