Microprolactinoma in a Woman with Sheehan’s Syndrome

A 24 year old woman presented with amenorrhoea and inability to conceive. One and a half year back she had an episode of massive antepartum haemorrhage. Endocrinal work up revealed deficiency of gonadotrophins, central hypothyroidism and paradoxically a very high level of serum prolactin, thus diagnosed as a case of Sheehan’s syndrome with hyperprolactinemia. Magnetic resonance imaging revealed a microadenoma of the pituitary gland. She was treated with thyroxine replacement, dopamine agonist cabergoline and cyclic estrogen and progesterone therapy. Ovulation was augmented with clomiphene citrate. She conceived and a small for gestational age baby was delivered with no apparent anomalies. Postnatally she had adequate lactation contrary to most women with postpartum hypopitiutarism.