Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan’s syndrome delayed till eighth decade

Sheehan’s syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function...

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Bibliographic Details
Published in:BMJ case reports 2010-05, Vol.2010 (may06 1), p.bcr0920092276-bcr0920092276
Main Authors: Wani, Abdul Majid, Hussain, Waleed Mohd, Mejally, Mousa Ali Al, Banjar, Abdulhakeem Amroon, Ali, Khaled Shawkat, Khoujah, Amer Mohd, Raja, Sadeya Hanif, Bafaraj, Mazen G, Miamini, Wail Al, Akhtar, Mubeena
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Age
Aged
Blood pressure
Breastfeeding & lactation
Coma
Delayed Diagnosis
Diabetes
Diagnosis, Differential
Female
Gangrene
Humans
Hypopituitarism - diagnosis
Hypopituitarism - drug therapy
Industrialized nations
Magnetic Resonance Imaging
Menstruation
Middle East
Obstetrics
Pituitary gland
Skin
Thyroxine - therapeutic use
Unusual Presentation of More Common Disease/Injury
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Summary:Sheehan’s syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited. Presentations such as malaise, fatigue, hypoglycaemia, decline in cognition, hyponatraemia, pancytopoenia, osteoporosis, secondary infertility, confusion and coma have all been reported. Two interesting cases of Sheehan’s syndrome are presented that were diagnosed in the eighth decade; one due to atypical presentation of recurrent hyponatraemia and confusion, another from hypoglycaemic coma and symptoms of malaise and lethargy.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.09.2009.2276