Sheehan syndrome

Abstract

Sheehan syndrome is an underestimated cause of hypopituitarism, which can be either partial or complete. It results from ischaemic necrosis of anterior pituitary during peripartum period leading to loss of one or more pituitary cell lines. Hyperplasia of pituitary gland during pregnancy increases demand for blood supply and at the same time compresses the pituitary gland. Severe postpartum haemorrhage leads to hypovolaemia and vasospasm of supplying vessels resulting in infarction of pituitary tissue. Congenital or acquired thrombophilia and autoimmunity exaggerate this phenomenon. Presentation is usually delayed by many years. It presents with symptoms of anterior pituitary hormone loss after a delay of many years. Rarely presentation may be acute or involve posterior pituitary as well. Low basal or stimulated pituitary hormones along with classic clinical setting clinches the diagnosis. Replacement of deficient hormones is the mainstay of treatment, however emphasis on better obstetric care to common masses would help to eradicate the disease in future.

Keywords: Sheehan syndrome, Hypopituitarism, Hormones..