Sheehan Syndrome Presenting as Central Diabetes Insipidus: A Rare Presentation of an Uncommon Disorder

Kumar, Saumya; Burrows, Daryl; Dang, Shyam; Simmons, Debra L.

doi:10.4158/ep10015.cr

Cited by 20 publications

(22 citation statements)

References 25 publications

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“…In our case, the MRI findings were normal on postpartum day 15 (7 days after the seizure). Two studies reported that the MRI scans were normal on postpartum day 6; in addition, another study reported that normal scans were obtained on day 19 [20, 21, 24]. Seven studies reported their early MRI findings [11, 13, 17, 19, 22, 23, 26].…”

Section: Discussionmentioning

confidence: 99%

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Matsuzaki

Endo

Ueda

et al. 2017

BMC Pregnancy Childbirth

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BackgroundSheehan’s syndrome occurs because of severe postpartum hemorrhage causing ischemic pituitary necrosis. Sheehan’s syndrome is a well-known condition that is generally diagnosed several years postpartum. However, acute Sheehan’s syndrome is rare, and clinicians have little exposure to it. It can be life-threatening. There have been no reviews of acute Sheehan’s syndrome and no reports of successful pregnancies after acute Sheehan’s syndrome. We present such a case, and to understand this rare condition, we have reviewed and discussed the literature pertaining to it. An electronic search for acute Sheehan’s syndrome in the literature from January 1990 and May 2014 was performed.Case presentationA 27-year-old woman had massive postpartum hemorrhage (approximately 5000 mL) at her first delivery due to atonic bleeding. She was transfused and treated with uterine embolization, which successfully stopped the bleeding. The postpartum period was uncomplicated through day 7 following the hemorrhage. However, on day 8, the patient had sudden onset of seizures and subsequently became comatose. Laboratory results revealed hypothyroidism, hypoglycemia, hypoprolactinemia, and adrenal insufficiency. Thus, the patient was diagnosed with acute Sheehan’s syndrome. Following treatment with thyroxine and hydrocortisone, her condition improved, and she was discharged on day 24.Her next pregnancy was established 2 years after her first delivery. She required induction of ovulation for the next conception. The pregnancy, delivery, and postpartum period were uneventful. An electronic search of the literature yielded 21 cases of acute Sheehan’s syndrome. Presenting signs varied, including adrenal insufficiency (12 cases), diabetes insipidus (4 cases), hypothyroidism (2 cases), and panhypopituitarism (3 cases), with a median time of presentation after delivery for each of those conditions being 7.9, 4, 18, and 9 days, respectively. Serial changes in magnetic resonance imaging were reported in some cases of acute Sheehan’s syndrome.ConclusionClinicians should be aware of the risk of acute Sheehan’s syndrome after a massive postpartum hemorrhage in order to diagnose it accurately and treat it promptly.

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Section: Discussionmentioning

confidence: 99%

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Matsuzaki

Endo

Ueda

et al. 2017

BMC Pregnancy Childbirth

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“…Kumar et al [18] reported a multigravida woman, who developed severe postpartum hemorrhage, disseminated intravascular coagulation followed by Sheehan's syndrome, postoperatively, she developed polyuria, laboratory evidence of diabetes insipidus and her clinical status improved significantly with intranasal desmopressin supplementation.…”

Section: Discussionmentioning

confidence: 99%

Partial Empty Sella Syndrome: A Case Report and Review

et al. 2013

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“…However, the disease may also manifest with even rarer signs. These include neuropsychiatric signs with acute onset (12), acute renal insufficiency (13), pancytopenia (14), and central diabetes mellitus (15). SS may…”

Section: Discussionmentioning

confidence: 99%

Miscible Two Diseases in Old Age: Hypopituitarism and Pseudogout

et al. 2016

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Calcium pyrophosphate dihydrate deposition disease is a disease characterized by collecting of crystals in hyaline cartilage, fibrocartilage and soft tissues, related to many endocrine and metabolic conditions, and seen more commonly in old age. Hypopituitarism may occur in old age with fatigue, decrease in libido, weight loss and musculoskeletal symptoms as a major cause of the overall condition impairment. As one gets older, the signs of these two diseases may progress even without any significant disease. The natural process which comes with old age, and pseudogout and hypopituitarism can mask one to another clinically and the symptoms of three situation may be overlapping. This can lead to difficulty and delay in diagnosis. Our case was an elderly female patient diagnosed with hypopituitarism and pseudogout.

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Sheehan Syndrome Presenting as Central Diabetes Insipidus: A Rare Presentation of an Uncommon Disorder

Cited by 20 publications

References 25 publications

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

A case of acute Sheehan’s syndrome and literature review: a rare but life-threatening complication of postpartum hemorrhage

Partial Empty Sella Syndrome: A Case Report and Review

Miscible Two Diseases in Old Age: Hypopituitarism and Pseudogout

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