Chronic Sheehan's Syndrome - A Differential to be Considered in Clinical Practice in Women with a History of Postpartum Hemorrhage.

adrenal insufficiency amenorrhea case report central hypothyroidism chronic delay in diagnosis fatigue hypothyroidism panhypopituitarism sheehan's syndrome

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
04 Dec 2019
Historique:
entrez: 16 1 2020
pubmed: 16 1 2020
medline: 16 1 2020
Statut: epublish

Résumé

Sheehan's syndrome is hypopituitarism due to pituitary gland necrosis resulting from hemorrhagic shock during pregnancy. It is a rare complication with varied manifestations and a considerable delay in diagnosis. We describe the case of a 36-year-old female with eight years of non-specific symptoms of generalized myalgias and intense fatigue managed symptomatically all these years. Further clinical assessment revealed amenorrhea and agalactia ongoing for several years without a clinical diagnosis. A good history and physical led to the diagnosis during a routine outpatient visit. She had significant improvement noted following the commencement of treatment. Previous case reports describe cases being diagnosed after one or other complications from long-term panhypopituitarism. Through this case, we want to illustrate that undiagnosed Sheehan's syndrome is associated with long-term morbidity, and there should be a high index of suspicion for it to be diagnosed during a routine clinical visit and thus prevent complications before a diagnosis can be made. It is essential to create awareness, especially in developed countries like the United States, where it has received less attention over the last few years.

Identifiants

pubmed: 31938584
doi: 10.7759/cureus.6290
pmc: PMC6942501
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e6290

Informations de copyright

Copyright © 2019, Jose et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Merin Jose (M)

Internal Medicine, Saint Peters University Hospital, New Brunswick, USA.

Saba Amir (S)

Internal Medicine, Saint Peters University Hospital, New Brunswick, USA.

Rajesh Desai (R)

Internal Medicine, Saint Peters University Hospital, New Brunswick, USA.

Classifications MeSH