Sheehans syndrome, also known as postpartum pituitary gland necrosis, is hypopituitarism decreased functioning of the pituitary gland, caused by ischemic necrosis due to blood loss and hypovolemic shock during and after childbirth. In 1937 sheehan reported 11 cases of women who died in the puerperium, all of whom had necrosis of the. Knowledge of this disease has been greatly broadened by the work of. Although his definitions are still valid, various studies and reports including new data have subsequently. Sheehan syndrome is the name given to postpartum hypopituitarism. Sheehan s syndrome on the web most recent articles. Sheehan syndrome is a condition that can occur in a woman who bleeds severely during childbirth. Sheehans syndrome ss, which was first described by hl sheehan, classically refers to postpartum hypopituitarism due to pituitary necrosis occurring during severe hypotension or shock secondary to massive bleeding at or just after the delivery. Download this books into available format 2019 update.
This document presents a clinical case of a patient who consulted due to late manifestations of this syndrome. Scribd is the worlds largest social reading and publishing site. Tratar as deficiencias hormonais com substitucao hormonal. Sheehan s syndrome is a wellknown cause of panhypopituitarism secondary to pituitary apoplexy, that generally occurs after an intra or postpartum bleeding episode characterized by severe. Introduction212 denitions2 the nature of war 214 the revolution in military affairs 217 postmodern war 219 new wars 221 conclusion 224. Postpartum hypopituitarism postpartum panhypopituitarism postpartum panhypopituitary syndrome postpartum pituitary necrosis simmonds disease. Patients with ss have varying degrees of anterior pituitary hormone deficiency. Sheehans syndrome ss is postpartum hypopituitarism caused by necrosis of the pituitary gland. Conditions that increase the risk of bleeding during childbirth and sheehan syndrome include multiple pregnancy twins or triplets and problems with the. Pathological and clinical findings of ss were first described by harold l. Sheehans syndrome is the name given to postpartum hypopituitarism, usually precipitated by massive uterine haemorrhage and hypovolemic shock during or after childbirth resulting into pituitary.
We report a 41yearold woman with a history of severe postpartum hemorrhage 18 years prior to presentation. Sheehan s syndrome ss, which was first described by hl sheehan, classically refers to postpartum hypopituitarism due to pituitary necrosis occurring during severe hypotension or shock secondary to massive bleeding at or just after the delivery. After all these tests were performed the diagnosis of ss was made. Sheehans syndrome ss is a parturitionrelated pituitary disease resulting from severe postpartum hemorrhage and can present with varying degrees of pituitary insufficiency. Very rarely pituitary infarction occurs with diabetic vasculitis, sickle cell anemia, and idiopathic disease most often called in these conditions as the simmonds.
Three months prior to being admitted to our hospital, the patient started to notice alopecia, generalized edema. Sheehan syndrome is a rare, acquired, pituitary hormone deficiency disorder resulting from pituitary necrosis following peri or postpartum hemorrhage. Patients with sheehans syndrome usually present with clinical features of anterior pituitary hormone deficiency. Pdf sheehans syndrome ss is called the acquired hypopituitarism in women due to peripartum pituitary necrosis and or severe hypotension. It is usually the result of severe hypotension or shock caused by massive haemorrhage during or after delivery. Necrotised areas of the adenohypophysis undergo organisation and form a fibrous scar figure 1. Endocrinologia basica y clinica, manual mo derno, 5. Postpartum pituitary necrosis or sheehans syndrome, it. Hyperprolactinemia in a patient with sheehan s syndrome. Extensive destruction of cells results in varying degrees of hypopituitarism.
The clear relationship between a destructive lesion of the anterior portion of the hypophysis and the striking deficiency syndrome associated with it was first described by simmonds, who attributed the ischemic necrosis to an infarct resulting from minute bacterial emboli lodging in the sinuses of the gland. Total score ranges from 0 to 3,600 being 0 the worst and 3,600 the best. Buen desarrollo del equilibrio y del esquema corporal. A case of sheehans syndrome developing mania following low dose corticosteroid therapy abstract sheehans syndrome postpartum pituitary necrosis is a rare complication of postpartum hemorrhage first described in 1937. O tratamento do hipopituitarismo tem tres objetivos 5. Sheehans syndrome ss occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. A case of sheehans syndrome developing mania following low. Pdf sheehans syndrome refers to the occurrence of hypopituitarism after delivery, usually preceded by postpartum hemorrhage. During this period of time, she experienced severe fatigue. Read sheehan s syndrome with complete bone marrow aplasia. A lack of these hormones can lead to a variety of symptoms. Nowadays, postpartum hypopituitarism is better known as sheehan syndrome whereas all other pituitary failure are known as simmonds disease.
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