Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report

Abstract

The present study reported on an unusual case of refractory hypotension induced by Sheehan syndrome with pituitary crisis and explored the causes and treatment of hypotension in hypopiptuitarism. Refractory hypotension is a rare and severe complication of longstanding hypopituitarism induced by Sheehan syndrome with pituitary crisis. A 48-year-old Chinese woman with pituitary crisis due to Sheehan syndrome developed refractory hypotension and received longstanding vasopressor blood pressure support and hormone replacement therapy. Besides normalized blood pressure, echocardiography over 3 months revealed partial reversibility of her cardiac function with hormone replacement therapy. Consistent numerous studies reviewed, hormone replacement therapy may improve cardiac function in patients with cardiomyopathy linked to Sheehan syndrome. A retrospective study of 77 cases with hypopituitarism encountered at Qilu Hospital of Shandong University (Jinan, China) was also performed and the incidence rate of hypotension was analyzed, revealing that the present case was the first of refractory hypotension induced by Sheehan syndrome with pituitary crisis at this institution in 16 years.

Perinatal Management and Outcomes of Pregnancy Following Sheehan Syndrome: A Case Report and Literature Review

“…The main characters of the pituitary crisis are volume depletion and low cardiac output. 35 Immediate and proper hormone replacement therapy is necessary. A dose of parenteral 50 to 100 mg of hydrocortisone is recommended for suspected adrenal crisis.…”

“…Acute pituitary crisis, also called acute pituitary insufficiency, is a life-threatening complication of Sheehan syndrome, the causes of which include infection, trauma, and other types of stress like labor or cesarean section. The main characters of the pituitary crisis are volume depletion and low cardiac output 35 . Immediate and proper hormone replacement therapy is necessary.…”