Sheehan's syndrome: Difference between revisions
Elcatracho (talk | contribs) (Created page with "==Background== *Also known as postpartum hypopituitarism *Caused by pituitary hypoperfusion and infarction usually in the setting of postpartum hemorrhage *During pregnanc...") |
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==Background== | ==Background== | ||
[[File:1806 The Hypothalamus-Pituitary Complex.jpg|thumb|Pituitary gland anatomic relations.]] | |||
[[File:Pituiary gland - regulatory hormones.png|thumb|Pitutiary gland physiology.]] | |||
*Also known as postpartum hypopituitarism | *Also known as postpartum hypopituitarism | ||
*Caused by pituitary hypoperfusion and infarction usually in the setting of [[postpartum hemorrhage]] | *Caused by pituitary hypoperfusion and infarction usually in the setting of [[postpartum hemorrhage]] | ||
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**Lethargy | **Lethargy | ||
**Weight loss | **Weight loss | ||
*Can occur any time from the immediate postpartum period to years after birth | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Adrenal crisis ddx}} | |||
==Evaluation== | ==Evaluation== | ||
*Evaluation of serum prolactin levels is not performed as it is difficult to differentiate low from normal serum prolactin levels | |||
===Workup=== | ===Workup=== | ||
*Workup should include testing of all anterior pituitary hormones | |||
*Patients should be evaluated and treated for adrenal insufficiency immediately as this can worsen pre-existing hypotension | |||
*Other pituitary hormones can be tested for 4-6 weeks after the initial insult | |||
===Diagnosis=== | ===Diagnosis=== | ||
==Management== | ==Management== | ||
*Currently no treatment is available but there is an ongoing small open-label pilot study looking at using recombinant human prolactin | |||
==Disposition== | ==Disposition== | ||
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==See Also== | ==See Also== | ||
*[[Pregnancy]] | *[[Pregnancy]] | ||
*[[Pituitary apoplexy]] | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Endocrinology]] | |||
[[Category:OBGYN]] | |||
Latest revision as of 16:25, 14 February 2024
Background
- Also known as postpartum hypopituitarism
- Caused by pituitary hypoperfusion and infarction usually in the setting of postpartum hemorrhage
- During pregnancy there is enlargement of the pituitary gland predisposing it to ischemia in low-flow states
Clinical Features
- Symptoms consistent with adrenal insufficiency, hypothyroidism and hypogonadism
- Inability to lactate
- Amenorrhea or oligomenorrhea
- Fatigue
- Cold intolerance
- Lethargy
- Weight loss
- Can occur any time from the immediate postpartum period to years after birth
Differential Diagnosis
Adrenal crisis
Evaluation
- Evaluation of serum prolactin levels is not performed as it is difficult to differentiate low from normal serum prolactin levels
Workup
- Workup should include testing of all anterior pituitary hormones
- Patients should be evaluated and treated for adrenal insufficiency immediately as this can worsen pre-existing hypotension
- Other pituitary hormones can be tested for 4-6 weeks after the initial insult
Diagnosis
Management
- Currently no treatment is available but there is an ongoing small open-label pilot study looking at using recombinant human prolactin