Sheehan's syndrome medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*Treatment involves appropriate hormone replacement therapy, which must be taken for the rest of your life that results in significant improvement and reversal of not only the physical symptoms but also the psychological symptoms.<ref name="pmid27034575">{{cite journal |vauthors=Parikh R, Buch V, Makwana M, Buch HN |title=The price of a 15-year delay in diagnosis of Sheehan's syndrome |journal=Proc (Bayl Univ Med Cent) |volume=29 |issue=2 |pages=212–3 |year=2016 |pmid=27034575 |pmc=4790577 |doi= |url=}}</ref><ref name="pmid19697029">{{cite journal |vauthors=Laway BA, Bhat JR, Mir SA, Khan RS, Lone MI, Zargar AH |title=Sheehan's syndrome with pancytopenia--complete recovery after hormone replacement (case series with review) |journal=Ann. Hematol. |volume=89 |issue=3 |pages=305–8 |year=2010 |pmid=19697029 |doi=10.1007/s00277-009-0804-9 |url=}}</ref><ref name="pmid15921942">{{cite journal |vauthors=Tanriverdi F, Unluhizarci K, Kula M, Guven M, Bayram F, Kelestimur F |title=Effects of 18-month of growth hormone (GH) replacement therapy in patients with Sheehan's syndrome |journal=Growth Horm. IGF Res. |volume=15 |issue=3 |pages=231–7 |year=2005 |pmid=15921942 |doi=10.1016/j.ghir.2005.03.005 |url=}}</ref> | *Treatment involves appropriate hormone replacement therapy, which must be taken for the rest of your life that results in significant improvement and reversal of not only the physical symptoms but also the psychological symptoms.<ref name="pmid27034575">{{cite journal |vauthors=Parikh R, Buch V, Makwana M, Buch HN |title=The price of a 15-year delay in diagnosis of Sheehan's syndrome |journal=Proc (Bayl Univ Med Cent) |volume=29 |issue=2 |pages=212–3 |year=2016 |pmid=27034575 |pmc=4790577 |doi= |url=}}</ref><ref name="pmid19697029">{{cite journal |vauthors=Laway BA, Bhat JR, Mir SA, Khan RS, Lone MI, Zargar AH |title=Sheehan's syndrome with pancytopenia--complete recovery after hormone replacement (case series with review) |journal=Ann. Hematol. |volume=89 |issue=3 |pages=305–8 |year=2010 |pmid=19697029 |doi=10.1007/s00277-009-0804-9 |url=}}</ref><ref name="pmid15921942">{{cite journal |vauthors=Tanriverdi F, Unluhizarci K, Kula M, Guven M, Bayram F, Kelestimur F |title=Effects of 18-month of growth hormone (GH) replacement therapy in patients with Sheehan's syndrome |journal=Growth Horm. IGF Res. |volume=15 |issue=3 |pages=231–7 |year=2005 |pmid=15921942 |doi=10.1016/j.ghir.2005.03.005 |url=}}</ref> | ||
*In patients with combined hypothyroidism and hypocortisolism, glucocorticoids(physiologic doses) are replaced first than thyroid hormone replacement. | *In patients with combined hypothyroidism and hypocortisolism, glucocorticoids (physiologic doses and increased doses in stress) are replaced first than thyroid hormone replacement. | ||
*DDAVP is the treatment of choice for patients with DI.<ref name="pmid18797595">{{cite journal |vauthors=Soares DV, Conceição FL, Vaisman M |title=[Clinical, laboratory and therapeutics aspects of Sheehan's syndrome] |language=Portuguese |journal=Arq Bras Endocrinol Metabol |volume=52 |issue=5 |pages=872–8 |year=2008 |pmid=18797595 |doi= |url=}}</ref> | *DDAVP is the treatment of choice for patients with DI.<ref name="pmid18797595">{{cite journal |vauthors=Soares DV, Conceição FL, Vaisman M |title=[Clinical, laboratory and therapeutics aspects of Sheehan's syndrome] |language=Portuguese |journal=Arq Bras Endocrinol Metabol |volume=52 |issue=5 |pages=872–8 |year=2008 |pmid=18797595 |doi= |url=}}</ref> | ||
*GH is replaced on case to case basis starting with a low dose(0.1-0.3mg/day) and titrated upwards by 0.1mg/d/month with repeated measurement of hormone levels every month initially for the first 6months followed by yearly measurements and is replaced once all other hormones have been replaced.<ref name="pmid20944496">{{cite journal |vauthors=Tessnow AH, Wilson JD |title=The changing face of Sheehan's syndrome |journal=Am. J. Med. Sci. |volume=340 |issue=5 |pages=402–6 |year=2010 |pmid=20944496 |doi=10.1097/MAJ.0b013e3181f8c6df |url=}}</ref> | *GH is replaced on case to case basis starting with a low dose(0.1-0.3mg/day) and titrated upwards by 0.1mg/d/month with repeated measurement of hormone levels every month initially for the first 6months followed by yearly measurements and is replaced once all other hormones have been replaced.<ref name="pmid20944496">{{cite journal |vauthors=Tessnow AH, Wilson JD |title=The changing face of Sheehan's syndrome |journal=Am. J. Med. Sci. |volume=340 |issue=5 |pages=402–6 |year=2010 |pmid=20944496 |doi=10.1097/MAJ.0b013e3181f8c6df |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Iqra Qamar M.D.[2]
Overview
Treatment involves appropriate hormone replacement therapy that results in complete recovery and reversal of symptoms.
Medical Therapy
- Treatment involves appropriate hormone replacement therapy, which must be taken for the rest of your life that results in significant improvement and reversal of not only the physical symptoms but also the psychological symptoms.[1][2][3]
- In patients with combined hypothyroidism and hypocortisolism, glucocorticoids (physiologic doses and increased doses in stress) are replaced first than thyroid hormone replacement.
- DDAVP is the treatment of choice for patients with DI.[4]
- GH is replaced on case to case basis starting with a low dose(0.1-0.3mg/day) and titrated upwards by 0.1mg/d/month with repeated measurement of hormone levels every month initially for the first 6months followed by yearly measurements and is replaced once all other hormones have been replaced.[5]
Medical Therapy
- ↑ Parikh R, Buch V, Makwana M, Buch HN (2016). "The price of a 15-year delay in diagnosis of Sheehan's syndrome". Proc (Bayl Univ Med Cent). 29 (2): 212–3. PMC 4790577. PMID 27034575.
- ↑ Laway BA, Bhat JR, Mir SA, Khan RS, Lone MI, Zargar AH (2010). "Sheehan's syndrome with pancytopenia--complete recovery after hormone replacement (case series with review)". Ann. Hematol. 89 (3): 305–8. doi:10.1007/s00277-009-0804-9. PMID 19697029.
- ↑ Tanriverdi F, Unluhizarci K, Kula M, Guven M, Bayram F, Kelestimur F (2005). "Effects of 18-month of growth hormone (GH) replacement therapy in patients with Sheehan's syndrome". Growth Horm. IGF Res. 15 (3): 231–7. doi:10.1016/j.ghir.2005.03.005. PMID 15921942.
- ↑ Soares DV, Conceição FL, Vaisman M (2008). "[Clinical, laboratory and therapeutics aspects of Sheehan's syndrome]". Arq Bras Endocrinol Metabol (in Portuguese). 52 (5): 872–8. PMID 18797595.
- ↑ Tessnow AH, Wilson JD (2010). "The changing face of Sheehan's syndrome". Am. J. Med. Sci. 340 (5): 402–6. doi:10.1097/MAJ.0b013e3181f8c6df. PMID 20944496.