Sheehan's syndrome laboratory findings: Difference between revisions

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__NOTOC__
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{{Sheehan's syndrome}}
{{Sheehan's syndrome}}
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}{{IQ}}  


==Overview==
==Overview==
*An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
Lab evaluation gives a picture of partial or panhypopituitarism. Laboratory findings consistent with the diagnosis of Sheehan's syndrome are including [[hyponatremia]], [[hypokalemia]], [[hypocalcemia]], [[hypomagnesemia]], [[hypophosphatemia]], [[anemia]], [[pancytopenia]], [[eosinophilia]], [[hypoalbuminemia]], low [[fasting plasma glucose]], and decreased levels of [[anterior pituitary]] [[hormones]] (free [[thyroxine]], [[estradiol]], [[cortisol]] levels). The most sensitive tests are inadequate [[prolactin]] and [[gonadotropin]] responses to stimulation.
*Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
*[Test] is usually normal among patients with [disease name].
*Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
*There are no diagnostic laboratory findings associated with [disease name].


==Laboratory Findings==
==Laboratory Findings==
*Laboratory findings consistent with the diagnosis of Sheehan syndrome include:  
*Laboratory findings consistent with the diagnosis of Sheehan's syndrome are including:
**Hyponatremia
**[[Hyponatremia]]<ref name="pmid8797063">{{cite journal |vauthors=Shoji M, Kimura T, Ota K, Ohta M, Sato K, Yamamoto T, Funyu T, Mori T, Tateyama M, Abe K |title=Cortical laminar necrosis and central pontine myelinolysis in a patient with Sheehan syndrome and severe hyponatremia |journal=Intern. Med. |volume=35 |issue=5 |pages=427–31 |year=1996 |pmid=8797063 |doi= |url=}}</ref><ref name="pmid1957856">{{cite journal |vauthors=Putterman C, Almog Y, Caraco Y, Gross DJ, Ben-Chetrit E |title=Inappropriate secretion of antidiuretic hormone in Sheehan's syndrome: a rare cause of postpartum hyponatremia |journal=Am. J. Obstet. Gynecol. |volume=165 |issue=5 Pt 1 |pages=1330–3 |year=1991 |pmid=1957856 |doi= |url=}}</ref><ref name="pmid19705625">{{cite journal |vauthors=Anfuso S, Patrelli TS, Soncini E, Chiodera P, Fadda GM, Nardelli GB |title=A case report of Sheehan's syndrome with acute onset, hyponatremia and severe anemia |journal=Acta Biomed |volume=80 |issue=1 |pages=73–6 |year=2009 |pmid=19705625 |doi= |url=}}</ref>
**Hypokalemia
**[[Hypokalemia]]
**Hypocalcemia
**[[Hypocalcemia]]
**Hypomagnesemia
**[[Hypomagnesemia]]
**Hypophosphatemia
**[[Hypophosphatemia]]
 
**[[Anemia]]<ref name="pmid19705625">{{cite journal |vauthors=Anfuso S, Patrelli TS, Soncini E, Chiodera P, Fadda GM, Nardelli GB |title=A case report of Sheehan's syndrome with acute onset, hyponatremia and severe anemia |journal=Acta Biomed |volume=80 |issue=1 |pages=73–6 |year=2009 |pmid=19705625 |doi= |url=}}</ref>
*Most sensitive test is inadequate prolactin and gonadotropin responses to stimulation.
**[[Pancytopenia]]<ref name="pmid19697029">{{cite journal |vauthors=Laway BA, Bhat JR, Mir SA, Khan RS, Lone MI, Zargar AH |title=Sheehan's syndrome with pancytopenia--complete recovery after hormone replacement (case series with review) |journal=Ann. Hematol. |volume=89 |issue=3 |pages=305–8 |year=2010 |pmid=19697029 |doi=10.1007/s00277-009-0804-9 |url=}}</ref>
*Baseline and stimulated anterior pituitary hormone level measurements.
**[[Eosinophilia]]<ref name="pmid2723566">{{cite journal |vauthors=Ratarasarn C, Rajatanavin R, Himathongkam T |title=Salient clinical features of Sheehan's syndrome |journal=J Med Assoc Thai |volume=72 |issue=1 |pages=41–7 |year=1989 |pmid=2723566 |doi= |url=}}</ref>
**[[Hypoalbuminemia]]
**Low [[fasting plasma glucose]]
**Elevated serum [[SGOT]]
**[[Thrombocytopenia]]
**Decreased levels of [[anterior pituitary]] [[hormones]] in blood:
***Low free [[thyroxine]]
***Low [[estradiol]]
***Decreased [[cortisol]] levels
*Most sensitive tests are inadequate [[prolactin]] and [[gonadotropin]] responses to stimulation.
*[[ACTH stimulation test]] is done after 3 months [[postpartum]], as [[adrenal gland]] takes 3 months to get [[Atrophic|atrophied]] in absence of [[ACTH stimulation test|ACTH stimulation]]. During this 3 month period, definitive diagnosis of [[Adrenocorticotropic hormone|ACTH]] and [[Growth hormone|GH]] deficiency can be made by other stimulation tests, such as [[insulin]]- or [[glucagon]]-induced [[hypoglycemia]].


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Medicine]]
[[Category:Endocrinology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]
[[Category:Obstetrics]]

Latest revision as of 00:09, 30 July 2020

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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

Lab evaluation gives a picture of partial or panhypopituitarism. Laboratory findings consistent with the diagnosis of Sheehan's syndrome are including hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia, hypophosphatemia, anemia, pancytopenia, eosinophilia, hypoalbuminemia, low fasting plasma glucose, and decreased levels of anterior pituitary hormones (free thyroxine, estradiol, cortisol levels). The most sensitive tests are inadequate prolactin and gonadotropin responses to stimulation.

Laboratory Findings

References

  1. Shoji M, Kimura T, Ota K, Ohta M, Sato K, Yamamoto T, Funyu T, Mori T, Tateyama M, Abe K (1996). "Cortical laminar necrosis and central pontine myelinolysis in a patient with Sheehan syndrome and severe hyponatremia". Intern. Med. 35 (5): 427–31. PMID 8797063.
  2. Putterman C, Almog Y, Caraco Y, Gross DJ, Ben-Chetrit E (1991). "Inappropriate secretion of antidiuretic hormone in Sheehan's syndrome: a rare cause of postpartum hyponatremia". Am. J. Obstet. Gynecol. 165 (5 Pt 1): 1330–3. PMID 1957856.
  3. 3.0 3.1 Anfuso S, Patrelli TS, Soncini E, Chiodera P, Fadda GM, Nardelli GB (2009). "A case report of Sheehan's syndrome with acute onset, hyponatremia and severe anemia". Acta Biomed. 80 (1): 73–6. PMID 19705625.
  4. Laway BA, Bhat JR, Mir SA, Khan RS, Lone MI, Zargar AH (2010). "Sheehan's syndrome with pancytopenia--complete recovery after hormone replacement (case series with review)". Ann. Hematol. 89 (3): 305–8. doi:10.1007/s00277-009-0804-9. PMID 19697029.
  5. Ratarasarn C, Rajatanavin R, Himathongkam T (1989). "Salient clinical features of Sheehan's syndrome". J Med Assoc Thai. 72 (1): 41–7. PMID 2723566.

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