Sheehan's syndrome history and symptoms: Difference between revisions

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{{CMG}}; {{AE}}{{IQ}}  
{{CMG}}; {{AE}}{{IQ}}  
==Overview==
==Overview==
The most common symptoms of [[Sheehan's syndrome|Sheehan's sydrome]] include [[lactation]] failure and failure to resume [[menstruation]] after [[parturition]]. Common symptoms include [[hot flushes]], decreased [[Pubic|pubi]]<nowiki/>c/[[axillary]] hair, [[hypotension]], [[hypoglycemia]], features of [[hypothyroidism]], [[hypoadrenalism]] and [[hypogonadism]].
The most common symptoms of [[Sheehan's syndrome|Sheehan's sydrome]] are including [[lactation]] failure and failure to resume [[menstruation]] after [[parturition]]. Common symptoms include [[hot flushes]], decreased [[Pubic|pubi]]<nowiki/>c/[[axillary]] hair, [[hypotension]], [[hypoglycemia]], features of [[hypothyroidism]], [[hypoadrenalism]], and [[hypogonadism]].


== History and Symptoms ==
== History and Symptoms ==


===History===
===History===
Patients with Sheehan syndrome may have a positive history of:
Patients with Sheehan's syndrome may have a positive history of:
*Severe or massive [[PPH]]
*Severe or massive [[PPH]]
*Pituitary mass
*[[Pituitary]] mass
*[[Coagulopathy]] such as [[DIC]]
*[[Coagulopathy]], such as [[DIC]]


===Common Symptoms===
===Common Symptoms===
Common symptoms of Sheehan syndrome include:
Common symptoms of Sheehan's syndrome are including:
*Agalactorrhea due to [[mammary gland]] [[atrophy]]<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*Agalactorrhea due to [[mammary gland]] [[atrophy]]<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*[[Amenorrhea]]/[[oligomenorrhea]]
*[[Amenorrhea]]/[[oligomenorrhea]]
Line 21: Line 21:
*Decreased/absent [[pubic]] or [[axillary]] hair<ref name="pmid21041170">{{cite journal |vauthors=Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH |title=Sheehan syndrome in Costa Rica: clinical experience with 60 cases |journal=Endocr Pract |volume=17 |issue=3 |pages=337–44 |year=2011 |pmid=21041170 |doi=10.4158/EP10145.OR |url=}}</ref>
*Decreased/absent [[pubic]] or [[axillary]] hair<ref name="pmid21041170">{{cite journal |vauthors=Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH |title=Sheehan syndrome in Costa Rica: clinical experience with 60 cases |journal=Endocr Pract |volume=17 |issue=3 |pages=337–44 |year=2011 |pmid=21041170 |doi=10.4158/EP10145.OR |url=}}</ref>
*[[Hypotension]]<ref name="pmid8557875">{{cite journal |vauthors=Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH |title=Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis |journal=Intensive Care Med |volume=21 |issue=10 |pages=847–9 |year=1995 |pmid=8557875 |doi= |url=}}</ref>
*[[Hypotension]]<ref name="pmid8557875">{{cite journal |vauthors=Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH |title=Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis |journal=Intensive Care Med |volume=21 |issue=10 |pages=847–9 |year=1995 |pmid=8557875 |doi= |url=}}</ref>
*Non-specific symptoms such as [[fatigue]], [[Muscle weakness|weakness]], [[anorexia]], [[malaise]], [[joint aches]] and [[dizziness]]
*Non-specific symptoms such as [[fatigue]], [[Muscle weakness|weakness]], [[anorexia]], [[malaise]], [[joint aches]], and [[dizziness]]
*Decreased [[libido]]
*Decreased [[libido]]
*Features of [[hypothyroidism]], such as:<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*Features of [[hypothyroidism]], such as:<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
Line 32: Line 32:
*Cognitive changes including [[psychosis]]<ref name="pmid23483784">{{cite journal |vauthors=Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J |title=Sheehan's syndrome presenting as psychosis: a rare clinical presentation |journal=Med J Islam Repub Iran |volume=27 |issue=1 |pages=35–7 |year=2013 |pmid=23483784 |pmc=3592941 |doi= |url=}}</ref>
*Cognitive changes including [[psychosis]]<ref name="pmid23483784">{{cite journal |vauthors=Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J |title=Sheehan's syndrome presenting as psychosis: a rare clinical presentation |journal=Med J Islam Repub Iran |volume=27 |issue=1 |pages=35–7 |year=2013 |pmid=23483784 |pmc=3592941 |doi= |url=}}</ref>
*[[Osteopenia]] and [[osteoporosis]]<ref name="pmid26993664">{{cite journal |vauthors=Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H |title=Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors |journal=J Clin Densitom |volume=19 |issue=4 |pages=413–418 |year=2016 |pmid=26993664 |doi=10.1016/j.jocd.2016.02.002 |url=}}</ref>
*[[Osteopenia]] and [[osteoporosis]]<ref name="pmid26993664">{{cite journal |vauthors=Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H |title=Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors |journal=J Clin Densitom |volume=19 |issue=4 |pages=413–418 |year=2016 |pmid=26993664 |doi=10.1016/j.jocd.2016.02.002 |url=}}</ref>
*[[Hypoglycemia]] and decreased [[insulin]] requirement in women with [[Diabetes mellitus type 1|Type 1 Diabetes]].
*[[Hypoglycemia]] and decreased [[insulin]] requirement in women with [[Diabetes mellitus type 1|Type 1 diabetes]]


===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of Sheehan syndrome include:
Less common symptoms of Sheehan's syndrome are including:
*[[Headache]]<ref name="pmid25223643">{{cite journal |vauthors=Hale B, Habib AS |title=Sheehan syndrome: acute presentation with severe headache |journal=Int J Obstet Anesth |volume=23 |issue=4 |pages=383–6 |year=2014 |pmid=25223643 |doi=10.1016/j.ijoa.2014.04.011 |url=}}</ref>
*[[Headache]]<ref name="pmid25223643">{{cite journal |vauthors=Hale B, Habib AS |title=Sheehan syndrome: acute presentation with severe headache |journal=Int J Obstet Anesth |volume=23 |issue=4 |pages=383–6 |year=2014 |pmid=25223643 |doi=10.1016/j.ijoa.2014.04.011 |url=}}</ref>
*Refractory [[hypotension]]<ref name="pmid28565814">{{cite journal |vauthors=Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL |title=Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report |journal=Exp Ther Med |volume=13 |issue=5 |pages=2097–2101 |year=2017 |pmid=28565814 |pmc=5443209 |doi=10.3892/etm.2017.4188 |url=}}</ref><ref name="pmid26113625">{{cite journal |vauthors=George A, Phillips M, Sweeney L, Colombo C |title=A 56 year old woman with syncope, weakness, and refractory hypotension |journal=BMJ |volume=350 |issue= |pages=h3387 |year=2015 |pmid=26113625 |doi= |url=}}</ref>
*Refractory [[hypotension]]<ref name="pmid28565814">{{cite journal |vauthors=Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL |title=Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report |journal=Exp Ther Med |volume=13 |issue=5 |pages=2097–2101 |year=2017 |pmid=28565814 |pmc=5443209 |doi=10.3892/etm.2017.4188 |url=}}</ref><ref name="pmid26113625">{{cite journal |vauthors=George A, Phillips M, Sweeney L, Colombo C |title=A 56 year old woman with syncope, weakness, and refractory hypotension |journal=BMJ |volume=350 |issue= |pages=h3387 |year=2015 |pmid=26113625 |doi= |url=}}</ref>
*[[Sick sinus syndrome|Sinus sick syndrome]] and [[cardiac arrest]]<ref name="pmid28129900">{{cite journal |vauthors=Bouznad N, Mghari GE, Hattaoui ME, Ansari NE |title=[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume= |issue= |pages= |year=2017 |pmid=28129900 |doi=10.1016/j.ancard.2016.12.007 |url=}}</ref><ref name="pmid25332716">{{cite journal |vauthors=Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q |title=Sick sinus syndrome associated with hypopituitarism: a case report and literature review |journal=J Biomed Res |volume=28 |issue=5 |pages=429–32 |year=2014 |pmid=25332716 |pmc=4197395 |doi=10.7555/JBR.28.20130099 |url=}}</ref><ref name="pmid25275267">{{cite journal |vauthors=Cao L, Lu Z, Zheng Y |title=Sheehan's syndrome with cardiac arrest: a case report and review of the literature |journal=Neuro Endocrinol. Lett. |volume=35 |issue=5 |pages=352–4 |year=2014 |pmid=25275267 |doi= |url=}}</ref>
*[[Sick sinus syndrome|Sinus sick syndrome]] and [[cardiac arrest]]<ref name="pmid28129900">{{cite journal |vauthors=Bouznad N, Mghari GE, Hattaoui ME, Ansari NE |title=[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume= |issue= |pages= |year=2017 |pmid=28129900 |doi=10.1016/j.ancard.2016.12.007 |url=}}</ref><ref name="pmid25332716">{{cite journal |vauthors=Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q |title=Sick sinus syndrome associated with hypopituitarism: a case report and literature review |journal=J Biomed Res |volume=28 |issue=5 |pages=429–32 |year=2014 |pmid=25332716 |pmc=4197395 |doi=10.7555/JBR.28.20130099 |url=}}</ref><ref name="pmid25275267">{{cite journal |vauthors=Cao L, Lu Z, Zheng Y |title=Sheehan's syndrome with cardiac arrest: a case report and review of the literature |journal=Neuro Endocrinol. Lett. |volume=35 |issue=5 |pages=352–4 |year=2014 |pmid=25275267 |doi= |url=}}</ref>
*Generalized [[seizures]] due to [[hyponatremia]].<ref name="pmid27034575">{{cite journal |vauthors=Parikh R, Buch V, Makwana M, Buch HN |title=The price of a 15-year delay in diagnosis of Sheehan's syndrome |journal=Proc (Bayl Univ Med Cent) |volume=29 |issue=2 |pages=212–3 |year=2016 |pmid=27034575 |pmc=4790577 |doi= |url=}}</ref>
*Generalized [[seizures]] due to [[hyponatremia]]<ref name="pmid27034575">{{cite journal |vauthors=Parikh R, Buch V, Makwana M, Buch HN |title=The price of a 15-year delay in diagnosis of Sheehan's syndrome |journal=Proc (Bayl Univ Med Cent) |volume=29 |issue=2 |pages=212–3 |year=2016 |pmid=27034575 |pmc=4790577 |doi= |url=}}</ref>
*[[Adrenal insufficiency]] causing [[asthenia]], [[anorexia]], and [[weakness]].
*[[Adrenal insufficiency]] causing [[asthenia]], [[anorexia]], and [[weakness]].


*[[Central diabetes insipidus]].<ref name="pmid447511">{{cite journal |vauthors=Weiner P, Ben-Israel J, Plavnick L |title=Sheehan's syndrome with diabetes insipidus. A case study |journal=Isr. J. Med. Sci. |volume=15 |issue=5 |pages=431–3 |year=1979 |pmid=447511 |doi= |url=}}</ref><ref name="pmid424117">{{cite journal |vauthors=Collins ML, O'Brien P, Cline A |title=Diabetes insipidus following obstetric shock |journal=Obstet Gynecol |volume=53 |issue=3 Suppl |pages=16S–17S |year=1979 |pmid=424117 |doi= |url=}}</ref><ref name="pmid17468192">{{cite journal |vauthors=Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F |title=Posterior pituitary function in Sheehan's syndrome |journal=Eur. J. Endocrinol. |volume=156 |issue=5 |pages=563–7 |year=2007 |pmid=17468192 |doi=10.1530/EJE-06-0727 |url=}}</ref><ref name="pmid6693547">{{cite journal |vauthors=Bakiri F, Benmiloud M, Vallotton MB |title=Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load |journal=J. Clin. Endocrinol. Metab. |volume=58 |issue=3 |pages=511–5 |year=1984 |pmid=6693547 |doi=10.1210/jcem-58-3-511 |url=}}</ref><ref name="pmid3652485">{{cite journal |vauthors=Jialal I, Desai RK, Rajput MC |title=An assessment of posterior pituitary function in patients with Sheehan's syndrome |journal=Clin. Endocrinol. (Oxf) |volume=27 |issue=1 |pages=91–5 |year=1987 |pmid=3652485 |doi= |url=}}</ref>
*[[Central diabetes insipidus]]<ref name="pmid447511">{{cite journal |vauthors=Weiner P, Ben-Israel J, Plavnick L |title=Sheehan's syndrome with diabetes insipidus. A case study |journal=Isr. J. Med. Sci. |volume=15 |issue=5 |pages=431–3 |year=1979 |pmid=447511 |doi= |url=}}</ref><ref name="pmid424117">{{cite journal |vauthors=Collins ML, O'Brien P, Cline A |title=Diabetes insipidus following obstetric shock |journal=Obstet Gynecol |volume=53 |issue=3 Suppl |pages=16S–17S |year=1979 |pmid=424117 |doi= |url=}}</ref><ref name="pmid17468192">{{cite journal |vauthors=Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F |title=Posterior pituitary function in Sheehan's syndrome |journal=Eur. J. Endocrinol. |volume=156 |issue=5 |pages=563–7 |year=2007 |pmid=17468192 |doi=10.1530/EJE-06-0727 |url=}}</ref><ref name="pmid6693547">{{cite journal |vauthors=Bakiri F, Benmiloud M, Vallotton MB |title=Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load |journal=J. Clin. Endocrinol. Metab. |volume=58 |issue=3 |pages=511–5 |year=1984 |pmid=6693547 |doi=10.1210/jcem-58-3-511 |url=}}</ref><ref name="pmid3652485">{{cite journal |vauthors=Jialal I, Desai RK, Rajput MC |title=An assessment of posterior pituitary function in patients with Sheehan's syndrome |journal=Clin. Endocrinol. (Oxf) |volume=27 |issue=1 |pages=91–5 |year=1987 |pmid=3652485 |doi= |url=}}</ref>
*[[Optic chiasm]] compression
*[[Optic chiasm]] compression
** [[Visual field loss]]
** [[Visual field loss]]

Revision as of 16:15, 1 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Overview

The most common symptoms of Sheehan's sydrome are including lactation failure and failure to resume menstruation after parturition. Common symptoms include hot flushes, decreased pubic/axillary hair, hypotension, hypoglycemia, features of hypothyroidism, hypoadrenalism, and hypogonadism.

History and Symptoms

History

Patients with Sheehan's syndrome may have a positive history of:

Common Symptoms

Common symptoms of Sheehan's syndrome are including:

Less Common Symptoms

Less common symptoms of Sheehan's syndrome are including:

References

  1. 1.0 1.1 "Sheehan Syndrome (Sheehan's Syndrome) | SYMPTOMA.com".
  2. Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH (2011). "Sheehan syndrome in Costa Rica: clinical experience with 60 cases". Endocr Pract. 17 (3): 337–44. doi:10.4158/EP10145.OR. PMID 21041170.
  3. Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH (1995). "Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis". Intensive Care Med. 21 (10): 847–9. PMID 8557875.
  4. Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J (2013). "Sheehan's syndrome presenting as psychosis: a rare clinical presentation". Med J Islam Repub Iran. 27 (1): 35–7. PMC 3592941. PMID 23483784.
  5. Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H (2016). "Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors". J Clin Densitom. 19 (4): 413–418. doi:10.1016/j.jocd.2016.02.002. PMID 26993664.
  6. Hale B, Habib AS (2014). "Sheehan syndrome: acute presentation with severe headache". Int J Obstet Anesth. 23 (4): 383–6. doi:10.1016/j.ijoa.2014.04.011. PMID 25223643.
  7. Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL (2017). "Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report". Exp Ther Med. 13 (5): 2097–2101. doi:10.3892/etm.2017.4188. PMC 5443209. PMID 28565814.
  8. George A, Phillips M, Sweeney L, Colombo C (2015). "A 56 year old woman with syncope, weakness, and refractory hypotension". BMJ. 350: h3387. PMID 26113625.
  9. Bouznad N, Mghari GE, Hattaoui ME, Ansari NE (2017). "[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases]". Ann Cardiol Angeiol (Paris) (in French). doi:10.1016/j.ancard.2016.12.007. PMID 28129900.
  10. Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q (2014). "Sick sinus syndrome associated with hypopituitarism: a case report and literature review". J Biomed Res. 28 (5): 429–32. doi:10.7555/JBR.28.20130099. PMC 4197395. PMID 25332716.
  11. Cao L, Lu Z, Zheng Y (2014). "Sheehan's syndrome with cardiac arrest: a case report and review of the literature". Neuro Endocrinol. Lett. 35 (5): 352–4. PMID 25275267.
  12. Parikh R, Buch V, Makwana M, Buch HN (2016). "The price of a 15-year delay in diagnosis of Sheehan's syndrome". Proc (Bayl Univ Med Cent). 29 (2): 212–3. PMC 4790577. PMID 27034575.
  13. Weiner P, Ben-Israel J, Plavnick L (1979). "Sheehan's syndrome with diabetes insipidus. A case study". Isr. J. Med. Sci. 15 (5): 431–3. PMID 447511.
  14. Collins ML, O'Brien P, Cline A (1979). "Diabetes insipidus following obstetric shock". Obstet Gynecol. 53 (3 Suppl): 16S–17S. PMID 424117.
  15. Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F (2007). "Posterior pituitary function in Sheehan's syndrome". Eur. J. Endocrinol. 156 (5): 563–7. doi:10.1530/EJE-06-0727. PMID 17468192.
  16. Bakiri F, Benmiloud M, Vallotton MB (1984). "Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load". J. Clin. Endocrinol. Metab. 58 (3): 511–5. doi:10.1210/jcem-58-3-511. PMID 6693547.
  17. Jialal I, Desai RK, Rajput MC (1987). "An assessment of posterior pituitary function in patients with Sheehan's syndrome". Clin. Endocrinol. (Oxf). 27 (1): 91–5. PMID 3652485.

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