Sheehan's syndrome overview: Difference between revisions
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==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
*Sheehan's syndrome, if left untreated lead to hypopituitarism and empty sella syndrome. | |||
*Common complications include adrenal crisis, hypotension, hypothyroidism and hypopituitarism. | |||
*Prognosis is generally excellent provided early diagnosis and management resulting in complete reversal of symptoms. | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 18:21, 22 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Iqra Qamar M.D.[2]
Overview
Historical Perspective
Sheehan syndrome was first discovered by Leon Konrad Gliński about a century ago and it was named after Harold Sheehan(1900-1988).[1][2]
Classification
There is no established system for the classification of Sheehan's syndrome.
Pathophysiology
Causes
- Common causes of Sheehan's syndrome include massive hemorrhage, hypotension during pregnancy, vascular compression, and vascular occlusion(thrombosis, DIC). Less common causes include vascular insufficiency due to CABG in older patients and snake bites(Russell's viper bites).
Differentiating ((Page name)) from Other Diseases
- Sheehan syndrome must be differentiated from lymphocytic hypophysitis, pituitary apoplexy, hypothyroidism, Addison's disease, panhypopititarism, empty sella syndrome, hypogonadotropic hypogonadism, Simmond's disease, hypoprolactinemia, menopause,female athlete triadand SAH.[3][4][5]
Epidemiology and Demographics
- The incidence of Sheehan's syndrome is difficult to assess.[6] It was found to be the 6th most common cause of GH deficiency with an incidence of 3.1% of cases.[7] In 2009, the prevalence of Sheehan's syndrome was estimated to be 5.1 per 100,000 women.It is less prevalent in developed countries due to better obstetrical care and maternal health awraeness.[8][9].It is still one of the most common causes of hypopituitarism in developing countries.[9].
Risk Factors
- Common risk factors in the development of Sheehan's syndrome include pregnancy, severe/massive PPH, pituitary mass, pre-existing vascular diseases, autoimmunity,type 1 Diabetes, DIC, smaller and rigid sella, multiple gestations, placental abnormalities and traumatic delivery.
Screening
- There is insufficient evidence to recommend routine screening for Sheehan's syndrome.
Natural History, Complications, and Prognosis
- Sheehan's syndrome, if left untreated lead to hypopituitarism and empty sella syndrome.
- Common complications include adrenal crisis, hypotension, hypothyroidism and hypopituitarism.
- Prognosis is generally excellent provided early diagnosis and management resulting in complete reversal of symptoms.
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
CT scan
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Template:WhoNamedIt
- ↑ H. L. Sheehan. Post-partum necrosis of anterior pituitary. The Journal of Pathology and Bacteriology, Chichester, 1937, 45: 189-214.
- ↑ Rolih CA, Ober KP (1993). "Pituitary apoplexy". Endocrinol. Metab. Clin. North Am. 22 (2): 291–302. PMID 8325288.
- ↑ Vidal E, Cevallos R, Vidal J, Ravon R, Moreau JJ, Rogues AM, Loustaud V, Liozon F (1992). "Twelve cases of pituitary apoplexy". Arch. Intern. Med. 152 (9): 1893–9. PMID 1520058.
- ↑ Lazaro CM, Guo WY, Sami M, Hindmarsh T, Ericson K, Hulting AL, Wersäll J (1994). "Haemorrhagic pituitary tumours". Neuroradiology. 36 (2): 111–4. PMID 8183446.
- ↑ Asaoka K (1977). "[A study on the incidence of post-partum hypopituitarism, (Sheehan's syndrome)]". Nihon Naibunpi Gakkai Zasshi (in Japanese). 53 (7): 895–909. PMID 303183.
- ↑ Abs R, Bengtsson BA, Hernberg-Stâhl E, Monson JP, Tauber JP, Wilton P, Wüster C (1999). "GH replacement in 1034 growth hormone deficient hypopituitary adults: demographic and clinical characteristics, dosing and safety". Clin. Endocrinol. (Oxf). 50 (6): 703–13. PMID 10468941.
- ↑ Feinberg EC, Molitch ME, Endres LK, Peaceman AM (2005). "The incidence of Sheehan's syndrome after obstetric hemorrhage". Fertil. Steril. 84 (4): 975–9. doi:10.1016/j.fertnstert.2005.04.034. PMID 16213852.
- ↑ 9.0 9.1 Krysiak R, Okopień B (2015). "[Sheehan's syndrome--a forgotten disease with 100 years' history]". Prz. Lek. (in Polish). 72 (6): 313–20. PMID 26817341.