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Table of Contents
LETTER TO THE EDITOR
Year : 2012  |  Volume : 16  |  Issue : 2  |  Page : 322-323

Sheehan's syndrome: Presented with hyponatremia and hypoglycemia after 14 years from delivery


Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya, Turkey

Date of Web Publication13-Mar-2012

Correspondence Address:
Selcuk Yaylaci
Department of Internal Medicine, Sakarya Education and Research Hospital, Sakarya
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.93783

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How to cite this article:
Yaylaci S, Demir MV, Aytürk S, Tamer A. Sheehan's syndrome: Presented with hyponatremia and hypoglycemia after 14 years from delivery. Indian J Endocr Metab 2012;16:322-3

How to cite this URL:
Yaylaci S, Demir MV, Aytürk S, Tamer A. Sheehan's syndrome: Presented with hyponatremia and hypoglycemia after 14 years from delivery. Indian J Endocr Metab [serial online] 2012 [cited 2019 Oct 14];16:322-3. Available from: http://www.ijem.in/text.asp?2012/16/2/322/93783

Sir,

Sheehan's syndrome (SS) is postpartum pituitary necrosis due to bleeding and hypovolemia. [1] According to the degree of damage to the pituitary, the symptoms may ocur immediately or later. The main symptoms are loss of libido, cessation of lactation, and secondary amenorrhea. [2] The first sign of symptoms may associate with hypoglycemia and hyponatremia. There are reports that it is a relatively common cause of hypoglycemia and hyponatremia. SS should be considered in the differential diagnosis of hyponatremia and hypoglycemia. [3]

A 49-year-old woman was admitted to our clinic with weight loss, nausea, and vomiting. We learned that currettage had been performed because of stillbirth and total abdominal hysterectomy had been performed because of excessive blooding 14 years ago. Hypoglycemia and hyponatremia were detected. Hormone profiles including cortisol, plasma ACTH, thyroid hormones, TSH, FSH, LH, and prolactin were all low. SS was suspected and confirmed by a pituitary and cerebral MRI which showed an empty sella turcica. We diagnosed pituitary insufficiency and started essential hormone replacement treatment. The patient's clinical picture improved dramatically after hormone replacement therapy.

It is difficult to determine the real incidence of SS because of geographic and racial differences. [4] We want to highlight the fact that Sheehan's is seen not only in developing countires, but also in Europe. SS may manifest long after the delivery with hypoglycemia and hyponatremia like our case.

 
   References Top

1.Kovacs K. Sheehan syndrome. Lancet 2003;361:520-2.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.Dejager S, Gerber S, Foubert L, Turpin G. Sheehan's syndrome: Differential diagnosis in the acute phase. J Intern Med 1998;244:261-6.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Bala M, Brünnler T, Guralnik V, Schölmerich J, Schäffler A. A 36-year old female patient presenting with hypoglycemic coma. Internist (Berl) 2009;50:606-11.  Back to cited text no. 3
    
4.Errarhay S, Kamaoui I, Bouchikhi C, Châara H, Bouguern H, Tizniti S, et al. Sheehan's syndrome a case report and literature review. Libyan J Med 2009;4:81-2.  Back to cited text no. 4
    




 

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