Sheehan's syndrome natural history, complications and prognosis

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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

Sheehan's syndrome leads to hypopituitarism and empty sella syndrome, if left untreated. Common complications are including adrenal crisis, hypotension, hypothyroidism, and hypopituitarism. Prognosis is generally excellent provided early diagnosis and management resulting in complete reversal of symptoms.

Sheehan's syndrome usually results in anterior pituitary shrinkage within 20 days, followed by disappearance of pituitary tissue in 6-8 week; resulting in hypopituitarism and empty sella syndrome.
The symptoms of Sheehan's syndrome can develop during immediate post-puerperal period to years after delivery.
It may result in sparing or reversal of gonadotropic dysfunction as few cases of successful pregnancies have been reported following Sheehan's syndrome.^[1]^[2]
If left untreated, lead to mitral regurgitation, pericardial effusion, and diminished left ventricular motion, adrenal crisis, hypopituitarism, and empty sella syndrome.^[3]

Prognosis is generally good, and results in reversal of symptoms once respective hormones are being replaced.

↑ Zargar AH, Masoodi SR, Laway BA, Sofi FA, Wani AI (1998). "Pregnancy in Sheehan's syndrome: a report of three cases". J Assoc Physicians India. 46 (5): 476–8. PMID 11273296.
↑ Moreira AC, Zanini Maciel LM, Foss MC, Tabosa Veríssimo JM, Iazigi N (1984). "Gonadotropin secretory capacity in a patient with Sheehan's syndrome with successful pregnancies". Fertil. Steril. 42 (2): 303–5. PMID 6745465.
↑ Laway BA, Ramzan M, Allai MS, Wani AI, Misgar RA (2016). "CARDIAC STRUCTURAL AND FUNCTIONAL ABNORMALITIES IN FEMALES WITH UNTREATED HYPOPITUITARISM DUE TO SHEEHAN SYNDROME: RESPONSE TO HORMONE REPLACEMENT THERAPY". Endocr Pract. 22 (9): 1096–103. doi:10.4158/EP161262.OR. PMID 27359291.