SHEEHAN’S SYNDROME WITH RECURRENT HYPONATREMIA AND ANEMIA: A CASE REPORT

Öz

Sheehan’s syndrome (SS) occurs due to ischemic pituitary necrosis after severe postpartum hemorrhage. The clinical spectrum of SS is wide and changes from non-specific complaints such as weakness, fatigue, and anemia to severe pituitary insufficiency including secondary adrenal failure and hypothyroidism resulting in coma and death. We present a case of Sheehan’s syndrome who had recurrent hyponatremia episodes due to the late diagnosis of the disorder.

Anahtar Kelimeler

• Sheehan’s syndrome
• postpartum hemorhage
• recurrent hyponatremia

Kaynakça

1. Keleştimur F. Sheehan's syndrome. Pituitary 2003; 6: 181-1
2. Sheehan H. Postpartum necrosis of the anterior pituitary. J Path Bacteriol 1937; 45: 189-214.
3. Kovacs K. Sheehan syndrome. Lancet 2003; 361: 5205
4. Karaca Z, Tanriverdi F, Unluhizarci K, Kelestimur F. Pregnancy and pituitary disorders European Journal of Endocrinology 2010; 162: 453-475.
5. Guven M, Bayram F, Guven K, Kelestimur F. Evaluation of patients admitted with hypoglycaemia to a teaching hospital in Central Anatolia. Postgrad Med J 2000; 76: 150-152.
6. Bunch TJ, Dunn WF, Basu A, Gosman RI. Hyponatremia and hypoglycemia in acute Sheehan’s syndrome. Gynecol Endocrinol 2002; 16: 419-423.
7. Huang YY, Ting MK, Hsu BRS, Tsar JS. Demonstration of reserved anterior pituitary function among patients with amenorrhea after postpartum hemorrhage. Gynecol Endocrinol 2000; 14: 99-104.
8. Anfuso S, Patrelli TS, Soncini E, et al. A case report of Sheehan’s syndrome with acute onset, hyponatremia and severe anemia Acta Biomed 2009; 80: 73-76.

9. Discala VA, Kinney MJ. Effects of myxedema on the renal diluting and concentrating mechanism. Am J Med 1971; 50: 325-335.
10. Roberts DM. Sheehan’s syndrome. Am Fam Physician 1998; 37: 223-227.
11. Boulanger E, Pagniez D, Roueff S, et al. Sheehan syndrome presenting as early post-partum hyponatraemia. Nephrol Dial Transplant 1999; 14: 2714-2715.
12. Sidorov J, Mitnick P. Postpartum hyponatremia. Am J Med 1987; 83: 183-184.
13. Danis R, Ozmen S, Parmaksiz E, Ozmen CA, Yazanel O. A Case of Sheehan’s Syndrome Admitting with Severe Hyponatremia Official Journal of the Turkish Society of Nephrology 2005; 14: 208-210.
14. Kelestimur F. GH deficiency and the degree of hypopituitarism. Clin Endocrinol (Oxf) 1995; 42: 4434
15. Putterman C, Almog Y, Caraco Y, Gross DJ, BenChetrit E. Inappropriate secretion of antidiuretic hormone in Sheehan’s syndrome: a rare cause of postpartum hyponatremia. Am J Obstet Gynecol 1991; 165: 1330-1333.
16. Skowsky WR, Kikuchi TA. The role of vasopressin in the impaired water excretion of myxoedema. Am J Med 1978; 64: 613.