Sheehan’s Syndrome Revisited: Underlying Autoimmunity or Hypoperfusion?

Sheehan’s syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017,...

Full description

Saved in:
Bibliographic Details
Published in:International journal of endocrinology 2018-01, Vol.2018 (2018), p.1-8
Main Authors: Rodríguez-Gutiérrez, René, Elizondo-Plazas, Anasofia, Rodríguez-Guajardo, René, Salcido-Montenegro, Alejandro, Borjas-Almaguer, Omar David, González-González, José Gerardo, Montes-de-Oca-Luna, Roberto
Format: Article
Language:English
Subjects:
Antibodies
Autoimmunity
Corticosteroids
Diabetes
Endocrinology
Glucose
Growth hormones
Health aspects
Hemorrhage
Insulin
Medical research
Medicine, Experimental
Obstetrics
Pathophysiology
Pituitary gland
Pregnant women
Proteins
Thyroid gland
Viral antibodies
Vital signs
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Sheehan’s syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed. Twenty women completed the study. Mean age was 26.35 (±5.83) years. The main etiology for severe PPH was uterine atony (65%) which resulted mostly in hypovolemic shock grades III-IV. Within the first four weeks after delivery, 95% of patients had at least one hormonal pituitary affected and 60% of the patients fulfilled diagnostic criteria for hypopituitarism. At the end of the study period, five patients (25%) were diagnosed with hypopituitarism (GH and cortisol axes affected). Anti-pituitary antibodies were negative in all patients. At 6 months follow-up, one in every four women with a history of moderate-to-severe PPH was found with asymptomatic nonautoimmune-mediated hypopituitarism. The role of autoimmunity in Sheehan’s syndrome remains uncertain. Further studies are needed to improve the remaining knowledge gaps.
ISSN:1687-8337
1687-8345
DOI:10.1155/2018/8415860