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Sheehan Syndrome: An Unusual Presentation Without Inciting Factors
Journal article   Open access   Peer reviewed

Sheehan Syndrome: An Unusual Presentation Without Inciting Factors

Ramya Sethuram, Daniel S. Guilfoil, Renee Amori, Julia Kharlip and Karen M. Berkowitz
Women's Health Reports, v 1(1)
24 Aug 2020
PMID: 33786491
url
https://www.liebertpub.com/doi/pdf/10.1089/whr.2019.0028View
Published, Version of Record (VoR) Open
url
https://doi.org/10.1089/whr.2019.0028View
Published, Version of Record (VoR) Open

Abstract

agalactia Case Report hypopituitarism postpartum amenorrhea postpartum headache Sheehan syndrome
Background: Sheehan syndrome (SS) is a rare complication of severe postpartum hemorrhage or hypotension during the processes of labor and delivery that results in ischemic pituitary infarction and necrosis. In this case report, we describe an unusual presentation of SS without inciting factors. Case Presentation: A 30-year-old multiparous woman presented 2 hours after a normal spontaneous vaginal delivery with a profound severe headache, and subsequent agalactia, dry skin, and mood changes. She was managed conservatively until 10 months postdelivery when she complained of persistent symptoms including amenorrhea. A brain magnetic resonance (MR) with pituitary imaging revealed findings consistent with SS. The patient's symptoms improved and ultimately resolved after levothyroxine, estrogen replacement therapy, and hydrocortisone were instituted. Conclusions: SS can present without recognized inciting factors. During the initial phase, women may present with profound headache and/or visual disturbances warranting neurological evaluation. A high index of suspicion and a brain MR with pituitary imaging should prompt early consideration of SS to aid in the diagnosis.

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Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
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