From Postpartum Hemorrhage to Acquired Hypopituitarism: Clinical Case

Da Hemorragia Pós-Parto ao Hipopituitarismo Adquirido: Caso Clínico

Authors

  • Joana Gomes da Cunha Serviço de Medicina Interna, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu. Portugal
  • Carolina Anjo Serviço de Medicina Interna, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu. Portugal
  • Gabriel Atanásio Serviço de Medicina Interna, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu. Portugal
  • Vera Romão Serviço de Medicina Interna, Unidade Local de Saúde de Viseu Dão-Lafões, Viseu. Portugal
  • Marta Gonçalves Ferreira Serviço de Endocrinologia, Unidade Local de Saúde Gaia-Espinho, Gaia, Portugal

DOI:

https://doi.org/10.60591/crspmi.223

Keywords:

Hypopituitarism, Postpartum Hemorrhage

Abstract

Sheehan’s syndrome is a rare disease associated with hypopituitarism that occurs because of ischemic pituitary necrosis due to severe postpartum hemorrhage. We report a case of a 34-year-old woman with a history of postpartum hemorrhage and subsequent fatigue, weight loss, hair loss, agalactia, amenorrhea, and dyspareunia. Laboratory results revealed microcytic and hypochromic anemia, hypogonadotropic hypogonadism central hypothyroidism, hypoprolactinemia, and adrenal insufficiency. The radiological evaluation helped to establish a definitive diagnosis. This condition, although increasingly less frequent, requires early diagnosis and appropriate treatment to reduce morbidity and mortality.

Downloads

Download data is not yet available.

References

Laway BA, Baba MS. Sheehan syndrome. J Pak Med Assoc. 2021;71:1282-12568.

Karaca Z, Laway BA, Dokmetas HS, Atmaca H, Kelestimur F. Sheehan syndrome. Nat Rev Dis Primers. 2016; 2:16092. doi: 10.1038/nrdp.2016.92.

Matsuzaki S, Endo M, Ueda Y, Mimura K, Kakigano A, Egawa-Takata T, et al. A case of acute Sheehan's syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage. BMC Pregnancy Childbirth. 2017;17:188. doi: 10.1186/s12884-017-1380-y.

Kovacs K. Sheehan syndrome. Lancet. 2003;361:520-2. doi: 10.1016/S0140-6736(03)12490-7.

Laway BA, Sharma A, Choh NA, Shaheen F, Wani AI. Sella turcica size in women with sheehan syndrome-a case-control study. Indian J Endocrinol Metab. 2023;27:431-5. doi: 10.4103/ijem.ijem_316_22.

Kanekar S, Bennett S. Imaging of neurologic conditions in pregnant patients. Radiographics. 2016;36:2102-22. doi: 10.1148/rg.2016150187.

Schury MP, Adigun R. Sheehan Syndrome. 2023 Sep 4. In: StatPearls. Treasure Island: StatPearls Publishing; 2024.

Woodmansee WW. Pituitary Disorders in Pregnancy. Neurol Clin. 2019;37:63-83. doi: 10.1016/j.ncl.2018.09.009.

Genetu A, Anemen Y, Abay S, Bante SA, Mihrete KM. A 45-year-old female patient with Sheehan's syndrome presenting with imminent adrenal crisis: a case report. J Med Case Rep. 2021;15:229. doi: 10.1186/s13256-021-02827-0.

Laway BA, Mir SA, Bashir MI, Bhat JR, Samoon J, Zargar AH. Prevalence of hematological abnormalities in patients with Sheehan's syndrome: response to replacement of glucocorticoids and thyroxine. Pituitary. 2011;14:39-43. doi: 10.1007/s11102-010-0255-2.

Diri H, Karaca Z, Tanriverdi F, Unluhizarci K, Kelestimur F. Sheehan's syndrome: new insights into an old disease. Endocrine. 2016;51:22-31. doi: 10.1007/s12020-015-0726-3.

RM hipófise: (A) - Redução da altura da hipófise, com hipossinal em T1 e reforço do sinal à periferia após administração de contraste; (B) - Redução da altura da hipófise com hipersinal em T2.

Published

26-09-2024

How to Cite

Gomes da Cunha, J., Anjo, C., Atanásio, G., Romão, V., & Gonçalves Ferreira, M. (2024). From Postpartum Hemorrhage to Acquired Hypopituitarism: Clinical Case: Da Hemorragia Pós-Parto ao Hipopituitarismo Adquirido: Caso Clínico. SPMI Case Reports, 2(3), 109–112. https://doi.org/10.60591/crspmi.223