Sheehan’s Syndrome

Pathophysiology

1) panhypopituitarism caused by ischemic necrosis of the pituitary 2) usually but not always caused by postpartum hemorrhage 3) can occur spontaneously 4) can occur after mutation in transcription factors

Signs and Symptoms

1) amenorrhea 2) hypothyroidism 3) decreased adrenal functioning 4) pallor 5) failure of lactation 6) loss of genital and axillary hair

Characteristic Test Findings

Laboratory – 1) decreased melano-stimulating hormone 2) decreased TSH 3) decreased prolactin 4) decreased corticotropin 5) decreased FSH 6) decreased LH

Histology/Gross Pathology

1) pituitary is vulnerable to ischemia during pregnancy because it is enlarged 2) diffuse ischemic necrosis of pituitary

Inheritance/Epidemiology

rare in Western countries owing to modern obstetric care; still common in less-developed areas of the world

Treatment

chronic replacement of low or missing hormones

Tips for USMLE

the term Sheehan’s syndrome was originally used to describe pituitary necrosis caused by postpartum hemorrhage; now is somewhat imprecisely used to describe the condition secondary to any cause