An uncommon cause of anaemia: Sheehan's syndrome

Melchardt, Thomas; Namberger, Konrad; Weiß, Lukas; Egle, Alexander; Faber, Viktoria; Greil, Richard

doi:10.1007/s00508-010-1480-4

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Similar to what occurred to our patient, there have been reports of individuals that were submitted to longstanding clinical treatment for chronic anemia, which never resolved, before actually being diagnosed with Sheehan's syndrome [14][15][16][17]. Gokalp et al, in 2009, showed that 80% of the studied population with this syndrome suffered from anemia.…”

Section: Discussionsupporting

confidence: 84%

A decade without diagnosis: Sheehan’s syndrome

Nascimento¹,

Nery²,

Marques³

et al. 2013

CRCM

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Sheehan's Syndrome (SS) occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. We report a 41-year-old woman with a history of severe postpartum hemorrhage 18 years prior to presentation. During this period of time, she experienced severe fatigue. Three months prior to being admitted to our hospital, the patient started to notice alopecia, generalized edema and cognitive impairment. After proper investigation, laboratory tests and clinical findings indicated panhypopituitarism. In addition to neuroimaging and past medical history, SS was diagnosed and treatment started. We emphasize the importance of thorough investigation, further diagnosis and management of this condition (especially in third world countries), since SS is a neurological and endocrinological emergency and potentially life threatening.

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Section: Discussionsupporting

confidence: 84%

A decade without diagnosis: Sheehan’s syndrome

Nascimento¹,

Nery²,

Marques³

et al. 2013

CRCM

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“…This is a 30-year-old woman, who presents an SS diagnosed 6 years after a hemorrhage of delivery, complicated by a deep vein thrombosis of the left poplitea. The only biological abnormality highlighted was normochromic normocytic anemia [11]. In their prospective study of 121 patients, Stolz et al, confirm the significant association between severe anemia and cerebral venous thrombosis [12].…”

Section: Discussionmentioning

confidence: 94%

"Recurrent Anemia, Deep Vein Thrombosis and Periodic Paralysis Hypokalemic as a Complication of Sheehan’s Syndrome: A Case Report"

Mahavivola

2023

BJSTR

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Introduction: Recurrent anemia, deep vein thrombosis and periodic paralysis hypokalemic have rarely been reported as a complication of Sheehan's Syndrome. The following was an unusual case reports detailing a patient presenting with all three above presentations. Case Presentation:The case consisted of a 51-year-old woman, admitted for deterioration of general condition, with vomiting and disorder consciousness. In her past medical history, she had experienced an abundant postpartum hemorrhage 21 years ago complicated by recurrent anemia treated with blood transfusion. She presented agalactorrhea and amenorrhea following the last delivery. Clinical examination showed Glasgow's score 12/15, low blood pressure 80/50 mmHg, heart rate at 60 bpm, mucocutaneous pallor, painful edema of the right lower limb. The laboratory findings showed microcytic anemia 8.9 g/ dl, high level of ferritin at 1642 ng/ml (4.63-204) and transferring saturation coefficient 70% (normal 20 and 40%), hyponatremia 103 mmol/L (136-144) and hypokalemia 3 mmol/L (3.5-5), high level of serum creatine kinase 2545 (25-170IU/L). Hormonal test found anterior pituitary insufficiency with destruction of the thyrotropic, corticotropic, gonadotropic and lactotrophic axis functions. MR images of the pituitary gland showing an empty sella turcica with no visualization of the anterior pituitary, posterior pituitary and pituitary stalk. Diagnostic of Sheehan's syndrome was finally established. In addition, she presented deep vein thrombosis of the posterior tibial vein of the right lower limb. Hydrocortisone ® substitution was complicated by periodic paralysis hypokalemic (low level of kalemia 2, 4 mmol/L (3.5-5). Her weakness and hypokalemia responded well to potassium supplement. Conclusion:From this case, panhypopituitarism should be counted among the possible causes of recurrent anemia. This anemia and secondary hemochromatosis could explain the deep vein thrombosis. Furthermore, clinicians should beware of this manifestation when administering steroids in the SS patients, especially to avoid periodic paralysis hypokalemic.

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“…Le diagnostic de SS est le plus souvent tardif ; dans 50 % des cas, il n'est porté que dix ans après l'événement obsté-trical, devant l'apparition tardive des signes classiques d'insuffisance hypophysaire (amaigrissement, asthénie, ané-mie, hypotension artérielle, aménorrhée secondaire) [2][3][4] ; le seul signe précoce, qui est malheureusement souvent négligé, est l'absence de montée laiteuse témoignant du défi-cit de la lignée lactotrope.…”

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