Sheehan's syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Sheehan syndrome must be differentiated from lymphocytic hypophysitis, pituitary apoplexy and SAH.

Differentiating Sheehan's Syndrome from other Diseases

Diseases	Course	History and Symptoms				Physical Examination	Laboratory Findings	Gold standard	CT/MRI	Other Findings
Sheehan's syndrome	Acute
Pituitary apoplexy
Lymphocytic hypophysitis
Subarachnoid hemorrhage
Empty sella syndrome	Chronic
Hypothyroidism
Hypogonadotropic hypogonadism
Hypoprolactinemia
Hypopituitarism
Hypoadrenalism

Differentiating Sheehan's syndrome on the basis of

Diseases	Course	History and Symptoms	Physical Examination	Laboratory Findings	Other Findings
							Physical Finding 1
Sheehan's Syndrome	Acute	+
Pituitary apoplexy
Lymphocytic hypophysitis
SAH
Empty sella syndrome	Chronic
Primary Hypothyroidism
Hypogonadotropic Hypogonadism
Hypoprolactinemia

Use if the above table can not be made

Differential Diagnosis	Similar Features	Differentiating Features
Differential 1	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 2	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 3	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 4	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
Differential 5	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].	On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].