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==Overview==
==Overview==
The most common symptoms of [[Sheehan's syndrome|Sheehan's sydrome]] include [[lactation]] failure and failure to resume [[menstruation]] after [[parturition]]. Common symptoms include [[hot flushes]], decreased [[Pubic|pubi]]<nowiki/>c/[[axillary]] hair, [[hypotension]], [[hypoglycemia]], features of [[hypothyroidism]], [[hypoadrenalism]] and [[hypogonadism]].
The most common symptoms of [[Sheehan's syndrome|Sheehan's sydrome]] are including [[lactation]] failure and failure to resume [[menstruation]] after [[parturition]]. Common symptoms include [[hot flushes]], decreased [[Pubic|pubi]]<nowiki/>c/[[axillary]] hair, [[hypotension]], [[hypoglycemia]], features of [[hypothyroidism]], [[hypoadrenalism]], and [[hypogonadism]].


== History and Symptoms ==
== History and Symptoms ==


===History===
===History===
Patients with Sheehan syndrome may have a positive history of:
Patients with Sheehan's syndrome may have a positive history of:
*Severe or massive [[PPH]]
*Severe or massive [[PPH]]
*Pituitary mass
*[[Pituitary]] mass
*[[Coagulopathy]] such as [[DIC]]
*[[Coagulopathy]], such as [[DIC]]


===Common Symptoms===
===Common Symptoms===
Common symptoms of Sheehan syndrome include:
Common symptoms of Sheehan's syndrome are including:
*Agalactorrhea due to [[mammary gland]] [[atrophy]]<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*Agalactorrhea due to [[mammary gland]] [[atrophy]]<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*[[Amenorrhea]]/[[oligomenorrhea]]
*[[Amenorrhea]]/[[oligomenorrhea]]
Line 21: Line 21:
*Decreased/absent [[pubic]] or [[axillary]] hair<ref name="pmid21041170">{{cite journal |vauthors=Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH |title=Sheehan syndrome in Costa Rica: clinical experience with 60 cases |journal=Endocr Pract |volume=17 |issue=3 |pages=337–44 |year=2011 |pmid=21041170 |doi=10.4158/EP10145.OR |url=}}</ref>
*Decreased/absent [[pubic]] or [[axillary]] hair<ref name="pmid21041170">{{cite journal |vauthors=Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH |title=Sheehan syndrome in Costa Rica: clinical experience with 60 cases |journal=Endocr Pract |volume=17 |issue=3 |pages=337–44 |year=2011 |pmid=21041170 |doi=10.4158/EP10145.OR |url=}}</ref>
*[[Hypotension]]<ref name="pmid8557875">{{cite journal |vauthors=Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH |title=Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis |journal=Intensive Care Med |volume=21 |issue=10 |pages=847–9 |year=1995 |pmid=8557875 |doi= |url=}}</ref>
*[[Hypotension]]<ref name="pmid8557875">{{cite journal |vauthors=Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH |title=Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis |journal=Intensive Care Med |volume=21 |issue=10 |pages=847–9 |year=1995 |pmid=8557875 |doi= |url=}}</ref>
*Non-specific symptoms such as [[fatigue]], [[Muscle weakness|weakness]], [[anorexia]], [[malaise]], [[joint aches]] and [[dizziness]]
*Non-specific symptoms such as [[fatigue]], [[Muscle weakness|weakness]], [[anorexia]], [[malaise]], [[joint aches]], and [[dizziness]]
*Decreased [[libido]]
*Decreased [[libido]]
*Features of [[hypothyroidism]], such as:<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
*Features of [[hypothyroidism]], such as:<ref name="urlSheehan Syndrome (Sheehans Syndrome) | SYMPTOMA.com">{{cite web |url=https://www.symptoma.com/en/info/sheehan-syndrome#epidemiology |title=Sheehan Syndrome (Sheehan's Syndrome) &#124; SYMPTOMA.com |format= |work= |accessdate=}}</ref>
Line 32: Line 32:
*Cognitive changes including [[psychosis]]<ref name="pmid23483784">{{cite journal |vauthors=Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J |title=Sheehan's syndrome presenting as psychosis: a rare clinical presentation |journal=Med J Islam Repub Iran |volume=27 |issue=1 |pages=35–7 |year=2013 |pmid=23483784 |pmc=3592941 |doi= |url=}}</ref>
*Cognitive changes including [[psychosis]]<ref name="pmid23483784">{{cite journal |vauthors=Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J |title=Sheehan's syndrome presenting as psychosis: a rare clinical presentation |journal=Med J Islam Repub Iran |volume=27 |issue=1 |pages=35–7 |year=2013 |pmid=23483784 |pmc=3592941 |doi= |url=}}</ref>
*[[Osteopenia]] and [[osteoporosis]]<ref name="pmid26993664">{{cite journal |vauthors=Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H |title=Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors |journal=J Clin Densitom |volume=19 |issue=4 |pages=413–418 |year=2016 |pmid=26993664 |doi=10.1016/j.jocd.2016.02.002 |url=}}</ref>
*[[Osteopenia]] and [[osteoporosis]]<ref name="pmid26993664">{{cite journal |vauthors=Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H |title=Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors |journal=J Clin Densitom |volume=19 |issue=4 |pages=413–418 |year=2016 |pmid=26993664 |doi=10.1016/j.jocd.2016.02.002 |url=}}</ref>
*[[Hypoglycemia]] and decreased [[insulin]] requirement in women with [[Diabetes mellitus type 1|Type 1 Diabetes]].
*[[Hypoglycemia]] and decreased [[insulin]] requirement in women with [[Diabetes mellitus type 1|Type 1 diabetes]]


===Less Common Symptoms===
===Less Common Symptoms===
Less common symptoms of Sheehan syndrome include:
Less common symptoms of Sheehan's syndrome are including:
*[[Headache]]<ref name="pmid25223643">{{cite journal |vauthors=Hale B, Habib AS |title=Sheehan syndrome: acute presentation with severe headache |journal=Int J Obstet Anesth |volume=23 |issue=4 |pages=383–6 |year=2014 |pmid=25223643 |doi=10.1016/j.ijoa.2014.04.011 |url=}}</ref>
*[[Headache]]<ref name="pmid25223643">{{cite journal |vauthors=Hale B, Habib AS |title=Sheehan syndrome: acute presentation with severe headache |journal=Int J Obstet Anesth |volume=23 |issue=4 |pages=383–6 |year=2014 |pmid=25223643 |doi=10.1016/j.ijoa.2014.04.011 |url=}}</ref>
*Refractory [[hypotension]]<ref name="pmid28565814">{{cite journal |vauthors=Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL |title=Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report |journal=Exp Ther Med |volume=13 |issue=5 |pages=2097–2101 |year=2017 |pmid=28565814 |pmc=5443209 |doi=10.3892/etm.2017.4188 |url=}}</ref><ref name="pmid26113625">{{cite journal |vauthors=George A, Phillips M, Sweeney L, Colombo C |title=A 56 year old woman with syncope, weakness, and refractory hypotension |journal=BMJ |volume=350 |issue= |pages=h3387 |year=2015 |pmid=26113625 |doi= |url=}}</ref>
*Refractory [[hypotension]]<ref name="pmid28565814">{{cite journal |vauthors=Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL |title=Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report |journal=Exp Ther Med |volume=13 |issue=5 |pages=2097–2101 |year=2017 |pmid=28565814 |pmc=5443209 |doi=10.3892/etm.2017.4188 |url=}}</ref><ref name="pmid26113625">{{cite journal |vauthors=George A, Phillips M, Sweeney L, Colombo C |title=A 56 year old woman with syncope, weakness, and refractory hypotension |journal=BMJ |volume=350 |issue= |pages=h3387 |year=2015 |pmid=26113625 |doi= |url=}}</ref>
*[[Sick sinus syndrome|Sinus sick syndrome]] and [[cardiac arrest]]<ref name="pmid28129900">{{cite journal |vauthors=Bouznad N, Mghari GE, Hattaoui ME, Ansari NE |title=[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume= |issue= |pages= |year=2017 |pmid=28129900 |doi=10.1016/j.ancard.2016.12.007 |url=}}</ref><ref name="pmid25332716">{{cite journal |vauthors=Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q |title=Sick sinus syndrome associated with hypopituitarism: a case report and literature review |journal=J Biomed Res |volume=28 |issue=5 |pages=429–32 |year=2014 |pmid=25332716 |pmc=4197395 |doi=10.7555/JBR.28.20130099 |url=}}</ref><ref name="pmid25275267">{{cite journal |vauthors=Cao L, Lu Z, Zheng Y |title=Sheehan's syndrome with cardiac arrest: a case report and review of the literature |journal=Neuro Endocrinol. Lett. |volume=35 |issue=5 |pages=352–4 |year=2014 |pmid=25275267 |doi= |url=}}</ref>
*[[Sick sinus syndrome|Sinus sick syndrome]] and [[cardiac arrest]]<ref name="pmid28129900">{{cite journal |vauthors=Bouznad N, Mghari GE, Hattaoui ME, Ansari NE |title=[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases] |language=French |journal=Ann Cardiol Angeiol (Paris) |volume= |issue= |pages= |year=2017 |pmid=28129900 |doi=10.1016/j.ancard.2016.12.007 |url=}}</ref><ref name="pmid25332716">{{cite journal |vauthors=Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q |title=Sick sinus syndrome associated with hypopituitarism: a case report and literature review |journal=J Biomed Res |volume=28 |issue=5 |pages=429–32 |year=2014 |pmid=25332716 |pmc=4197395 |doi=10.7555/JBR.28.20130099 |url=}}</ref><ref name="pmid25275267">{{cite journal |vauthors=Cao L, Lu Z, Zheng Y |title=Sheehan's syndrome with cardiac arrest: a case report and review of the literature |journal=Neuro Endocrinol. Lett. |volume=35 |issue=5 |pages=352–4 |year=2014 |pmid=25275267 |doi= |url=}}</ref>
*Generalized [[seizures]] due to [[hyponatremia]].<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>
*Generalized [[seizures]] due to [[hyponatremia]]<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>
*[[Adrenal insufficiency]] causing [[asthenia]], [[anorexia]], and [[weakness]].
*[[Adrenal insufficiency]] causing [[asthenia]], [[anorexia]], and [[weakness]].


*[[Central diabetes insipidus]].<ref name="pmid447511">{{cite journal |vauthors=Weiner P, Ben-Israel J, Plavnick L |title=Sheehan's syndrome with diabetes insipidus. A case study |journal=Isr. J. Med. Sci. |volume=15 |issue=5 |pages=431–3 |year=1979 |pmid=447511 |doi= |url=}}</ref><ref name="pmid424117">{{cite journal |vauthors=Collins ML, O'Brien P, Cline A |title=Diabetes insipidus following obstetric shock |journal=Obstet Gynecol |volume=53 |issue=3 Suppl |pages=16S–17S |year=1979 |pmid=424117 |doi= |url=}}</ref><ref name="pmid17468192">{{cite journal |vauthors=Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F |title=Posterior pituitary function in Sheehan's syndrome |journal=Eur. J. Endocrinol. |volume=156 |issue=5 |pages=563–7 |year=2007 |pmid=17468192 |doi=10.1530/EJE-06-0727 |url=}}</ref><ref name="pmid6693547">{{cite journal |vauthors=Bakiri F, Benmiloud M, Vallotton MB |title=Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load |journal=J. Clin. Endocrinol. Metab. |volume=58 |issue=3 |pages=511–5 |year=1984 |pmid=6693547 |doi=10.1210/jcem-58-3-511 |url=}}</ref><ref name="pmid3652485">{{cite journal |vauthors=Jialal I, Desai RK, Rajput MC |title=An assessment of posterior pituitary function in patients with Sheehan's syndrome |journal=Clin. Endocrinol. (Oxf) |volume=27 |issue=1 |pages=91–5 |year=1987 |pmid=3652485 |doi= |url=}}</ref>
*[[Central diabetes insipidus]]<ref name="pmid447511">{{cite journal |vauthors=Weiner P, Ben-Israel J, Plavnick L |title=Sheehan's syndrome with diabetes insipidus. A case study |journal=Isr. J. Med. Sci. |volume=15 |issue=5 |pages=431–3 |year=1979 |pmid=447511 |doi= |url=}}</ref><ref name="pmid424117">{{cite journal |vauthors=Collins ML, O'Brien P, Cline A |title=Diabetes insipidus following obstetric shock |journal=Obstet Gynecol |volume=53 |issue=3 Suppl |pages=16S–17S |year=1979 |pmid=424117 |doi= |url=}}</ref><ref name="pmid17468192">{{cite journal |vauthors=Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F |title=Posterior pituitary function in Sheehan's syndrome |journal=Eur. J. Endocrinol. |volume=156 |issue=5 |pages=563–7 |year=2007 |pmid=17468192 |doi=10.1530/EJE-06-0727 |url=}}</ref><ref name="pmid6693547">{{cite journal |vauthors=Bakiri F, Benmiloud M, Vallotton MB |title=Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load |journal=J. Clin. Endocrinol. Metab. |volume=58 |issue=3 |pages=511–5 |year=1984 |pmid=6693547 |doi=10.1210/jcem-58-3-511 |url=}}</ref><ref name="pmid3652485">{{cite journal |vauthors=Jialal I, Desai RK, Rajput MC |title=An assessment of posterior pituitary function in patients with Sheehan's syndrome |journal=Clin. Endocrinol. (Oxf) |volume=27 |issue=1 |pages=91–5 |year=1987 |pmid=3652485 |doi= |url=}}</ref>
*[[Optic chiasm]] compression
*[[Optic chiasm]] compression
** [[Visual field loss]]
** [[Visual field loss]]

Revision as of 16:15, 1 September 2017

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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

The most common symptoms of Sheehan's sydrome are including lactation failure and failure to resume menstruation after parturition. Common symptoms include hot flushes, decreased pubic/axillary hair, hypotension, hypoglycemia, features of hypothyroidism, hypoadrenalism, and hypogonadism.

History and Symptoms

History

Patients with Sheehan's syndrome may have a positive history of:

Common Symptoms

Common symptoms of Sheehan's syndrome are including:

Less Common Symptoms

Less common symptoms of Sheehan's syndrome are including:

References

  1. ↑ 1.0 1.1 "Sheehan Syndrome (Sheehan's Syndrome) | SYMPTOMA.com".
  2. ↑ Gei-Guardia O, Soto-Herrera E, Gei-Brealey A, Chen-Ku CH (2011). "Sheehan syndrome in Costa Rica: clinical experience with 60 cases". Endocr Pract. 17 (3): 337–44. doi:10.4158/EP10145.OR. PMID 21041170.
  3. ↑ Kaufmann P, Lax SF, Radner H, Eber B, Leuger A, Smolle KH (1995). "Severe hypotension and coma secondary to unrecognized chronic anterior hypophysitis". Intensive Care Med. 21 (10): 847–9. PMID 8557875.
  4. ↑ Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J (2013). "Sheehan's syndrome presenting as psychosis: a rare clinical presentation". Med J Islam Repub Iran. 27 (1): 35–7. PMC 3592941. PMID 23483784.
  5. ↑ Chihaoui M, Yazidi M, Chaker F, Belouidhnine M, Kanoun F, Lamine F, Ftouhi B, Sahli H, Slimane H (2016). "Bone Mineral Density in Sheehan's Syndrome; Prevalence of Low Bone Mass and Associated Factors". J Clin Densitom. 19 (4): 413–418. doi:10.1016/j.jocd.2016.02.002. PMID 26993664.
  6. ↑ Hale B, Habib AS (2014). "Sheehan syndrome: acute presentation with severe headache". Int J Obstet Anesth. 23 (4): 383–6. doi:10.1016/j.ijoa.2014.04.011. PMID 25223643.
  7. ↑ Liang L, Liu JB, Chen FQ, Zhao J, Zhang XL (2017). "Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report". Exp Ther Med. 13 (5): 2097–2101. doi:10.3892/etm.2017.4188. PMC 5443209. PMID 28565814.
  8. ↑ George A, Phillips M, Sweeney L, Colombo C (2015). "A 56 year old woman with syncope, weakness, and refractory hypotension". BMJ. 350: h3387. PMID 26113625.
  9. ↑ Bouznad N, Mghari GE, Hattaoui ME, Ansari NE (2017). "[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases]". Ann Cardiol Angeiol (Paris) (in French). doi:10.1016/j.ancard.2016.12.007. PMID 28129900.
  10. ↑ Zhao D, Zhang Q, Lu J, Zhang G, Lu H, Huang J, Shan Q (2014). "Sick sinus syndrome associated with hypopituitarism: a case report and literature review". J Biomed Res. 28 (5): 429–32. doi:10.7555/JBR.28.20130099. PMC 4197395. PMID 25332716.
  11. ↑ Cao L, Lu Z, Zheng Y (2014). "Sheehan's syndrome with cardiac arrest: a case report and review of the literature". Neuro Endocrinol. Lett. 35 (5): 352–4. PMID 25275267.
  12. ↑ 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.
  13. ↑ Weiner P, Ben-Israel J, Plavnick L (1979). "Sheehan's syndrome with diabetes insipidus. A case study". Isr. J. Med. Sci. 15 (5): 431–3. PMID 447511.
  14. ↑ Collins ML, O'Brien P, Cline A (1979). "Diabetes insipidus following obstetric shock". Obstet Gynecol. 53 (3 Suppl): 16S–17S. PMID 424117.
  15. ↑ Atmaca H, Tanriverdi F, Gokce C, Unluhizarci K, Kelestimur F (2007). "Posterior pituitary function in Sheehan's syndrome". Eur. J. Endocrinol. 156 (5): 563–7. doi:10.1530/EJE-06-0727. PMID 17468192.
  16. ↑ Bakiri F, Benmiloud M, Vallotton MB (1984). "Arginine-vasopressin in postpartum panhypopituitarism: urinary excretion and kidney response to osmolar load". J. Clin. Endocrinol. Metab. 58 (3): 511–5. doi:10.1210/jcem-58-3-511. PMID 6693547.
  17. ↑ Jialal I, Desai RK, Rajput MC (1987). "An assessment of posterior pituitary function in patients with Sheehan's syndrome". Clin. Endocrinol. (Oxf). 27 (1): 91–5. PMID 3652485.

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