Sheehan's syndrome physical examination
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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
Patients with Sheehan's syndrome usually appear fatigued, lethargic and weight gain. Physical examination is usually remarkable for bradycardia, hypotension, pallor and signs suggestive of respective hormonal deficiency. Clinical features depend upon the severity of hypopitutarism.
Physical Examination
Clinical features depend upon the severity of hypopitutarism that results from Sheehan's syndrome. Almost all the patients have GH, prolactin and gonadotropin deficiency and the majority has ACTH and TSH deficiency.[1][2][3][1][2]
Hypopituitarism | Presentation |
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Mild | Remains undiagnosed for many years |
Less severe |
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Severe |
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Appearance of the Patient
Vital Signs
Skin
- Pallor
- Areolar Hypopigmentation
- Coarse and dry skin
- Hair loss
HEENT
Genitourinary
Neuromuscular
- Patient is usually oriented to time, place and person
Extremities
- Pitting edema of the upper/lower extremities (myxedema)
- Muscle wasting
- Delayed relaxation of deep tendon reflexes
References
- ↑ 1.0 1.1 Dökmetaş HS, Kilicli F, Korkmaz S, Yonem O (2006). "Characteristic features of 20 patients with Sheehan's syndrome". Gynecol. Endocrinol. 22 (5): 279–83. doi:10.1080/09513590600630504. PMID 16785150.
- ↑ 2.0 2.1 Sert M, Tetiker T, Kirim S, Kocak M (2003). "Clinical report of 28 patients with Sheehan's syndrome". Endocr. J. 50 (3): 297–301. PMID 12940458.
- ↑ Keleştimur F (2003). "Sheehan's syndrome". Pituitary. 6 (4): 181–8. PMID 15237929.