Hyponatremia and hypoglycemia in acute Sheehan's syndrome

T. J. Bunch, W. F. Dunn, A. Basu, R. I. Gosman

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

We report the case of a 23-year-old Saudi Arabian woman who presented to the medical intensive care unit with severe hyponatremia and hypoglycemia following a Cesarean section delivery complicated by hemorrhage due to disseminated intravascular coagulopathy. She was treated successfully for adrenal insufficiency acutely, and was later discharged on hormone replacement therapy. To our knowledge, this is the first case report of acute Sheehan's syndrome presenting with both hyponatremia and suggestive hypoglycemia. Pituitary necrosis is an uncommon complication of peripartum hemorrhagic shock. Since the initial description by Sheehan in 1937, the incidence of the syndrome has gradually declined through improved management of hemodynamic complications leading to the infarction of the gland1,2. There are many studies describing complications of late Sheehan's syndrome; however, relatively few contain descriptions of the acute phase. In addition, the diagnosis of this syndrome is often determined after resolution of the acute process with resultant lack of data regarding immediate endocrine and imaging abnormalities3. In this report, we describe the complete endocrine and imaging assessment of a patient presenting in critical condition due to necrosis of the pituitary gland in the immediate postpartum period.

Original languageEnglish (US)
Pages (from-to)419-423
Number of pages5
JournalGynecological Endocrinology
Volume16
Issue number5
DOIs
StatePublished - Oct 2002

Keywords

  • Hypoglycemia
  • Hyponatremia
  • Inappropriate ADH Syndrome
  • Pituitary Apoplexy
  • Pituitary Gland
  • Pituitary Insufficiency
  • Puerperium

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Obstetrics and Gynecology

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