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Sheehan Syndrome

Smita Carroll, MD, MBA and Tiffany A. Moore Simas, MD, MPH, MEd, FACOG Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Sheehan syndrome is a rare disorder of postpartum panhypopituitarism occurring secondary to ischemia and subsequent necrosis of the pituitary gland, classically associated with sever...

DIAGNOSIS

HISTORY

  • Suspect syndrome in postpartum patient with hypotension, hypoglycemia, and/or lack of milk production (2).

  • Patients may initially present with

    • Failure to lactate or difficulty with la...

TREATMENT

ALERT

Complete loss of pituitary function is life-threatening and requires immediate treatment.

 

MEDICATION

First Line

  • Hypocortisolism: Hydrocortisone is replaced first to avoid adrenal crisis. ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

See “Treatment.” Follow individual hormone replacement levels per standard recommendations. 

PATIENT EDUCATION

American College of Obstetricians a...

REFERENCES

1
Kovacs K. Sheehan syndrome. Lancet.  2003;361(9356):520–522. [View Abstract on OvidMedline]
2
Tessnow AH, Wilson JD. The changing face of Sheehan’s syndrome. Am J Med Sci.  2010;34...

ADDITIONAL READING

  • Diri H, Karaca Z, Tanriverdi F, et al. Sheehan’s syndrome: new insights into an old disease. Endocrine.  2016;51(1):22–31. [View Abstract on OvidMedline]

  • Gokalp D, Alpagat G, Tu...

SEE ALSO

Hypopituitarism 

CODES

ICD10

E23.0 Hypopituitarism 

ICD9

253.2 Panhypopituitarism 

SNOMED

237684005 Sheehan’s syndrome (disorder) 

CLINICAL PEARLS

  • Sheehan syndrome is a rare disorder of postpartum panhypopituitarism due to ischemia and subsequent necrosis of the pituitary gland classically secondary to severe postpartum hemorrhag...

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