Sheehan Syndrome: An Unusual Presentation Without Inciting Factors.
Sheehan Syndrome: An Unusual Presentation Without Inciting Factors.
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DOI：
10.1089/whr.2019.0028
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Berkowitz KM
中科院分区：
文献类型：
--
作者：
Sethuram R;Guilfoil DS;Amori R;Kharlip J;Berkowitz KM
背景：Sheehan综合征(SS)是一种罕见的产后严重出血或分娩过程中的低血压，导致缺血性垂体梗塞和坏死的并发症。在此病例报告中，我们描述了一种不寻常的无刺激因素的SS的表现。病例介绍：一位30岁的经产妇女在正常自然阴道分娩2小时后出现严重头痛，随后出现无乳症、皮肤干燥和情绪变化。她一直接受保守治疗，直到产后10个月，她抱怨持续的症状，包括闭经。脑部核磁共振(MR)和脑垂体成像显示结果与SS一致。患者的症状在左旋甲状腺素、雌激素替代治疗和氢化可的松治疗后得到改善和最终缓解。结论：SS可以在没有识别的刺激因素的情况下出现。在最初阶段，女性可能会出现严重的头痛和/或视觉障碍，需要进行神经学评估。高度怀疑和脑部MR脑垂体成像应促使早期考虑SS以帮助诊断。
Background: Sheehan syndrome (SS) is a rare complication of severe postpartum hemorrhage or hypotension during the processes of labor and delivery that results in ischemic pituitary infarction and necrosis. In this case report, we describe an unusual presentation of SS without inciting factors. Case Presentation: A 30-year-old multiparous woman presented 2 hours after a normal spontaneous vaginal delivery with a profound severe headache, and subsequent agalactia, dry skin, and mood changes. She was managed conservatively until 10 months postdelivery when she complained of persistent symptoms including amenorrhea. A brain magnetic resonance (MR) with pituitary imaging revealed findings consistent with SS. The patient's symptoms improved and ultimately resolved after levothyroxine, estrogen replacement therapy, and hydrocortisone were instituted. Conclusions: SS can present without recognized inciting factors. During the initial phase, women may present with profound headache and/or visual disturbances warranting neurological evaluation. A high index of suspicion and a brain MR with pituitary imaging should prompt early consideration of SS to aid in the diagnosis.
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影响因子：
3.1
作者：
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通讯作者：
Kimura T
影响因子：
1.3
作者：
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通讯作者：
Gümele, HR
影响因子：
5.8
作者：
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通讯作者：
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影响因子：
5
作者：
Gladstone, JP;Dodick, DW;Evans, R
通讯作者：
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影响因子：
3.2
作者：
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通讯作者：
Zhu, Huijuan