Révélations cardiaques atypiques rares du syndrome de Sheehan : à propos de trois cas

Bouznad, N.; Mghari, G. El; Hattaoui, Mustapha El; Ansari, N. El

doi:10.1016/j.ancard.2016.12.007

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…In conclusion, screening patients by using only TSH and morning cortisol testing will miss a diagnosis of central hypopituitarism [ 2 ]. Diagnosis can be especially challenging in developed countries because the incidence of cases is low, symptoms are often vague, and patients can have late crises and unusual presentations such as severe hyponatremia, pancytopenia, cardiac tamponade, psychosis, and even cardiac arrest [ 2 , 14 , 15 ]. Some of these abnormalities and conditions can resolve with hormone supplementation, which is reassuring.…”

Section: Discussionmentioning

confidence: 99%

A Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia

Sadiq

Chowdhury

2021

Am J Case Rep

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Patient: Female, 46-year-old Final Diagnosis: Sheehan syndrome Symptoms: Fatigue • light-headedness Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Rare disease Background: Sheehan syndrome (pituitary necrosis after postpartum hemorrhage) can present in various ways, depending on the hormones that are deficient. There may be a long delay to diagnosis of over a decade because symptoms are often vague and pituitary dysfunction progresses gradually. We describe a case of a patient with acute presentation of Sheehan syndrome 7 years after the obstetric event and with no clear precipitating event. Case Report: A 46-year-old woman with a history of hyperlipidemia and transaminitis came to the clinic for evaluation of hypotension and syncope. She had a history of longstanding anhedonia, fatigue, and postpartum hemorrhage 7 years previously and had undergone medical evaluations with her primary doctor with no cause found. Laboratory results showed anemia, central hypothyroidism, and adrenal insufficiency. A diagnosis of Sheehan syndrome was made. Conclusions: Sheehan syndrome is a rare condition of progressive pituitary dysfunction, which can present with nonspecific symptoms and a myriad of laboratory abnormalities until an adrenal crisis is triggered years after the precipitating event. Screening patients for hypopituitarism by free thyroxine levels and adrenocorticotropic hormone (ACTH) stimulation testing is vital for determining whether hypopituitarism is the cause in the appropriate clinical scenario. Use of thyroid-stimulating hormone levels and morning cortisol testing alone will miss this diagnosis, and free thyroxine levels and ACTH stimulation testing are vital.

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Section: Discussionmentioning

confidence: 99%

A Case of Sheehan Syndrome 7 Years Postpartum with Transaminitis and Hyperlipidemia

Sadiq

Chowdhury

2021

Am J Case Rep

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“…It was first described in 1937, and since then, its occurrence has been steadily declining as a consequence of better maternal care throughout pregnancy and during delivery 7. However, it might still be an under-recognised problem in the rural settings, especially in the developing countries, like in the case described here.…”

Section: Discussionmentioning

confidence: 68%

Sheehan’s syndrome presenting as cardiac tamponade

Mittal¹,

Goel

Talupula

et al. 2018

BMJ Case Reports

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A 50-year-old woman presented with progressive dyspnoea and oedema with rapid deterioration over the last few days. Clinical examination revealed hypotension with cold clammy skin, raised jugular venous pressure and muffled heart sounds and was diagnosed to have cardiac tamponade, later confirmed on two-dimensional echocardiography. However, patient had bradycardia, and the other striking examination findings were coarse facies with pallor, madarosis, absent axillary and pubic hair and breast atrophy. Her blood sugar level was also low. Detailed history revealed an episode of postpartum haemorrhage with lactation failure and early menopause. Pericardiocentesis was done with a pig-tail catheter. Hormone profile and MRI brain confirmed the diagnosis of Sheehan's syndrome. Patient improved on treatment with thyroxine and hydrocortisone supplementation and was discharged with education about stress dosing.

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“…[ 23 ] Patients with SS have been reported to develop pleural and pericardial effusions and sometimes even cardiac tamponade. [ 24 ] In untreated patients with SS, nearly half of the patients have pericardial effusion, mitral regurgitation, and reduced left ventricular mass. However, upon achieving euthyroid and eucortisol states, these cardiac abnormalities appear to resolve.…”

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confidence: 99%