Sheehan's syndrome: a single centre experience

Background: Sheehan's syndrome (SS) occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. It is one of the most common causes of hypopituitarism in developing countries. Objective: To study the clinical profile of patients with SS presenting to the Endocrinology Department at a tertiary care teaching hospital in South India. Methods: All patients diagnosed as SS during the study period of 2007-2012 were identified. Their clinical, biochemical, hormonal, radiological and bone mineral density (BMD) data were collected. Results: Eighteen patients were identified. Median age of diagnosis was 40 years [interquartile range (IQR = 32- 51years); median (IQR) diagnostic delay was 11 (5-17years)]. Failure to resume menstruation and lactation failure was the most common clinical presentation. The median total tetraiodothyronine (T4), peak stimulated cortisol, stimulated growth hormone (GH), and prolactin (PRL) levels were low. The gonadotropins [follicle stimulating hormone (FSH) and luteinizing hormone (LH)] were inappropriately normal in the presence of amenorrhea. Hyponatremia was the most common electrolyte abnormality seen in 14 patients. Seven patients had anaemia and five of them had normocytic normochromic anaemia. BMD assessment (n = 9) was suggestive of low bone mass. Conclusion: SS resulted in multiple pituitary hormone deficiencies in all the patients. Hyponatremia, anaemia, and low bone mass were frequently seen in patients with SS.